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    Old 10-08-2003, 09:14 PM   #1
    gharari
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    Post Successstory and other nucleoplasty patients: How was your recovery?

    I am on week three of recovery and am moving and sitting with more pain than before the surgery. I know I shouldn't expect too much yet, but it would feel great to hear some other experiences with this procedure.

    What was your recovery like?

    How are you feeling now?

    __________________
    -28 year old male
    -6'0" 195 pounds
    -5 years chronic pain in lower back
    -Done PT, 2 epidurals, and NSAIDs
    -MRI shows herniation in L5-S1
    -diskogram confirmed diskogenic pain in L5-S1 and L4-L5
    -had numerous doctor's opinons regarding Fusion, microdiskectomy, nucleoplasty, and IDET.
    -M.D.'s: Michael Wolff - Physiatrist, Dennis Crandall - Orthopedic Surgeon, Curtis Dickman - Neurosurgeon, Anthony Yeung - Orthopedic Surgeon
    -Considering IDET and or Nucleoplasty as recommended by Dr. Wolff
    -Leaning away from IDET due to it's longer recovery time.
    -Nucleoplasty treatment on L5-S1 and L4-L5 on 9/18/03

     
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    Old 10-08-2003, 11:46 PM   #2
    successtory
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    Hi gharari,

    I knew I was better the moment I was able to walk out of the surgery room. I couldn't walk in. But on the pain side....it FELT swollen. Even though it was so swollen I couldn't walk anymore (but then there wasn't much left of l5/s1 and l4/l5 was close behind)...it was different. By the end of 2 weeks, I actually felt like I could walk a football field. I could too. oops, forgot I had to walk back though. dummy. hehe

    So was down for an extra week after that smart move. never did that again. kept all my walking close to home. You prolly won't start feeling better until your 4th through 6th week. You should get "that itch" (you know, that healing itchy feeling) in the 6-8 week timeframe. It works perfectly with the time you are supposed to start PT stuff...and it really takes that "itch" out and makes you feel better.

    #1 Keep icing your back.
    #2 Don't sit for longer than 10 min. at a time!
    #3 Don't bend, lift or make any fast twists/turns
    #4 Learn how to get out of a bed & car correctly
    #5 Listen and heed your body messages
    #6 Eat lots of fruits & vegies
    #7 Stop doing housework & stuff that hurts
    #8 Use gidgets & gadgets to assist you in daily life
    #9 Be kind to your back, it was just dissected & BBQ'd

    These are the top 10.....oops, I forgot number 10. Have faith and give yourself massages, picturing a whole and healthy disk (etc.). Believe that you are getting well and know you are working to that day when you can say "what pain?"

    I HAVE had those days. It is still very hard. As no body wants to hear a whiner. I just moved into a 4 bedroom house that was completely trashed by the previous tenants. Believe you me....it is still VERY hard. I work on controlling the pain on a daily basis. It is only in the past week (of MAJOR hard work) that I have taken vicodin. Pills I had from last year that I just didn't "need" anymore.

    Under normal daily living circumstances....my pain levels range from a 1 to 3. Over-doing can get me to a 5. Stupid moves get me to a 6(ish)....I haven't been over that since my surgery though. Going into my surgery I was rated a 9.5+/10 -- so I would say I have done VERY well in comparison.

    There are many that don't do well the first 5 weeks. Then at the end of the 5th week...it is like all of a sudden, everything just "falls into place". Suddenly, you wake up not even realizing you aren't hurting anymore (like you were). Just be careful...we all tend to (want to) click our heels over this event. Anyway, hope this info helps. I'm getting tired now. Take care.


    ------------------
    successtory
    Oct 2000: Repetitive Stress Injury-Inverted Hernia
    Feb 2001: MRI. Shows only slight bulge at L4-L5
    Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
    Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
    Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.

     
    Old 10-09-2003, 05:39 AM   #3
    khoff
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    Successstory -

    If you can only sit for 10 min at a time, how do you eat? I am scheduled for my nucleo on 10/20. I have a small central herniation L5-S1. I am trying to make all my arrangements and planning now, but I know I have no help since everyone I know is scattered throughout the U.S.
    My biggest concern is food shopping, especially perishables. Trying to everything I can now, but have no real freezer except mini one in fridge. How did you eat?

     
    Old 10-09-2003, 06:11 AM   #4
    Mary Anne9998
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    Yes and what about driving? I have a very quiet job that I can stand and sit as I wish, but is 25 miles from home. I only have two weeks of leave left, thanks to my back all year. So I need to be able to get to work and truthfully after I get here don't have to do much to get a pay check. But I definately need the pay check.

     
    Old 10-10-2003, 03:14 PM   #5
    mokita
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    Hi Ken!

    Just wondering about your dilemma w/ food storage. I'll be having Nucleoplasty, too...waiting to get approved by insurance...then, will probably schd for early Jun to have people to help.

    As for food...do you belong to a church? or FOE? or some other organization? If so, then maybe you could 'borrow' someone's freezer, make some meals ahead of time that microwave well (rigatoni, meatloaf-freeze raw, cook- manicotti, sloppy joe) and have someone bring couple at a time?

    Will you be able to get Home Healthcare for a little while after the surgery? Perhaps they'd have some ideas to help you out?

    I sure hope you get some help w/ the food issue! [img]http://www.healthboards.com/ubb/love1.gif[/img]

    Karen

    ------------------
    9/00 24 hour labor, baby post,tailbone hurts
    12/00 MRI -normal,still hurt - begin vicodin
    2/8/02 2nd girl,C-Sec
    '00-'02 PT + meds
    11/02 Referred to Neuro
    3/03 MRI bulge L3-L4, neural foramen,Sup aspect S1 and L5 Nerve root involvement-Neuro Refers to PM
    3 ESI's - little help
    5/9 - Discogram - Tear L4 Oversedated, False Negative
    PMDoc wants consult
    7/8- Dept Head ClCl cnslt-order Coccyx Xray
    Displaced Coccyx
    7/28 Caudal Epidural xray & coccygeal manip
    8/12 - 2nd caudal inj
    8/14 -coccyx manip AGAIN
    9/25 ReEval @ Clinic 10/6 Discogram Positive L4-L5 fissure
    Scheduling Nucleoplasty & Decompression

     
    Old 10-12-2003, 05:58 AM   #6
    khoff
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    Karen -

    Well, I am scheduled for the nucleoplasty on L5-S1 Monday Oct 20th at 9am. Found a service that will give me a ride and back. That takes care of one thing. As for food, just went shopping today to load up as best as I could. As luck has it, I also found an ad in our local paper for a service that will food shop for you. Don't know the cost, but hey, it helps to know they are there. I am truly grateful.
    Finishing up everything this week before I have the procedure. The hardest part will be waiting to get well enough so I can go back to PT and exercise again.
    I am not nervous about the procedure, just those thoughts that sometimes c reep up about will I get better or will I have to live with back pain all my life. The emotional is just as hard as the physical.
    But I am so into getting better, whatever it takes, no matter how much exercise, PT, anything it takes. Give it all ya got and stay positive, where the mind leads the body will go.
    When you go for insurance, here is a real tip my doctor told me. I have Aetna. They do not cover nucleoplasty. But the code the doctor bills for the procedure is 62287. For Aetna, they use CBT codes. I think it is 0216.
    But the bottom line is Aetna will cover percutaneous disc decompression if you get your doctor to send a letter of medical neccesity to Aetna. There are 5 criteria for getting approved. I know all this because i did this in the summer and got approved for the procedure. They will pay about 60% of my cost.
    I don't know if you have Aetna, but if you do and you need help, let me know and I'll show you how to do it. Most other insurance companies work kind of similar.

    So now I sit and wait for the procedure. I have researched nucleoplasty for about 10 months now. I have seen doctors who perform it, done research on nucleus volume, thr exact procedure itself, even called Arthrocare and spoke with the medical director.
    Everything is always a chance, but I figure it is better than surgery right now. Always think conservative and move up from there if you need it.

    I certainly will be posting alot about the time of the procedure and afterwards as long as I can. Write anytime!

    Ken

     
    Old 10-12-2003, 08:22 AM   #7
    Mary Anne9998
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    Ken,
    Wishing you the best with the procedure, and please keep us posted!!!!! I go Nov 4th for the first appt to get an Xray and injection to see if the height is good enough on one of the discs for IDET, and after that surgery(the other three discs involved are okay for it) and have recovered then on to the neucleoplasty, so will want to hear how you did.

    ------------------
    Back spasm episode requiring a week in hospital-1998
    MRI 1998 showed bulge at L5S1. Doc gives me Oxycondin, Celebrex, Quinine Sulfate, Celexa. Took myself off these, reaction to Celebrex then Relafin, then Vioxx.
    July 1999 Pain Management series of three steroid injections, didn't help.
    Physical therapy and TENS unit, neither helped.
    MRI Jan.2001 referred to specialist
    Discogram March 2001 showed 4 of 5 lumbars bulged, surgeon says fusion out of question. Aquatic therapy seemed to make me feel better overall but did nothing for back.
    Third MRI Dec 2002, in middle of major episode with back that didn't end until March 2003. Traction therapy total failure. Results read of MRI said no change.
    Sept 2003 Neucleoplasty specialist showed me the tears in two of the lumbars and leaking.
    Pain has progressed into hips and down back of legs. Standing has been lowered to 15 minutes from 30.
    Drugs of choice ibuprofen 800mg 3xdaily.
    Vicodin as needed.

     
    Old 10-12-2003, 11:09 PM   #8
    successtory
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    Hi all,

    How did I eat if I could only sit for 10 min at a time? Easy....I ate laying down or standing up. It took about a year and a half for me to sit through a meal without having to "jump up and down" throughout the entire 45 minute meal. You know...it hurts to sit so you stand for a while, you get tired so you sit, and it hurts so you stand for a while, you get tired so you sit, and it hurts so you stand for a while. You know the routine.

    It takes quite a while to actually "feel comfortable" while sitting. I still don't "feel comfortable" most of the time ESPECIALLY if I don't have my TushCush with me. It is not sharp pains (unless I've pushed it), but very noticeable and bothersome....and just makes me WANT to be standing instead of sitting. As for commuting...there are other options and others have stated. Carpools, trains, friends/family, church, etc.

    And keeping your food handy and cold? Keep an ice chest next to your bed...along with a box of "dry foods". This is mostly for those times when you just need something. The ice box (a small one) holds fruits and stuff you want cold (ice packs and/or water or drinks). Make sure you plan out everything you are going to need. There are very few things more frustrating than walking back & forth because you forgot this or didn't get that while you were up and around. That will save you on pain later.

    I hope I have clarified and answered your questions. Good luck to you guys!


    ------------------
    successtory
    Oct 2000: Repetitive Stress Injury-Inverted Hernia
    Feb 2001: MRI. Shows only slight bulge at L4-L5
    Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
    Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
    Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.

     
    Old 10-18-2003, 04:09 PM   #9
    gharari
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    Talking

    Thanks for your replies!

    Kenneth:

    I would actually love some advice. I am still trying to get Aeyna to cover my nucleoplasty. They declined my pre-authorization based on the statement that I am supposed to be "a candidate for open laminectomy" to be covered for nucleoplasty.

    That doesn't make sense to me since laminectomy is to treat non-discogenic pain, isn't it?

    What's your advice?

    ------------------
    -28 year old male
    -6'0" 195 pounds
    -5 years chronic pain in lower back
    -Done PT, 2 epidurals, and NSAIDs
    -MRI shows herniation in L5-S1
    -diskogram confirmed diskogenic pain in L5-S1 and L4-L5
    -had numerous doctor's opinons regarding Fusion, microdiskectomy, nucleoplasty, and IDET.
    -M.D.'s: Michael Wolff - Physiatrist, Dennis Crandall - Orthopedic Surgeon, Curtis Dickman - Neurosurgeon, Anthony Yeung - Orthopedic Surgeon
    -Considering IDET and or Nucleoplasty as recommended by Dr. Wolff
    -Leaning away from IDET due to it's longer recovery time.
    -Nucleoplasty treatment on L5-S1 and L4-L5 on 9/18/03
    __________________
    -28 year old male
    -6'0" 195 pounds
    -5 years chronic pain in lower back
    -Done PT, 2 epidurals, and NSAIDs
    -MRI shows herniation in L5-S1
    -diskogram confirmed diskogenic pain in L5-S1 and L4-L5
    -had numerous doctor's opinons regarding Fusion, microdiskectomy, nucleoplasty, and IDET.
    -M.D.'s: Michael Wolff - Physiatrist, Dennis Crandall - Orthopedic Surgeon, Curtis Dickman - Neurosurgeon, Anthony Yeung - Orthopedic Surgeon
    -Considering IDET and or Nucleoplasty as recommended by Dr. Wolff
    -Leaning away from IDET due to it's longer recovery time.
    -Nucleoplasty treatment on L5-S1 and L4-L5 on 9/18/03

     
    Old 10-19-2003, 04:35 AM   #10
    khoff
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    Gharari -

    The clinical policy bulletin number for Aetna is 0016 if you can get onto their site. It states below the following: (Note it says Percutaneous lumbar discectomy)


    Percutaneous lumbar discectomy, manual and automated, or laser-assisted disc decompression (LADD) is covered for treatment of herniated lumbar discs when ALL of the following are met:
    The patient is otherwise a candidate for open laminectomy; and
    The patient has failed at least 6 weeks of conservative therapy; and
    Diagnostic studies show that the nuclear bulge of the disc is contained within the annulus; and
    The patient has had no previous surgery or chemonucleolysis of the disc to be treated; and
    The patient must have typical clinical symptoms of radicular pain corresponding to the level of disc involvement.

    Do NOT use the word nucleoplasty as they will immediately deny it. Use Percutaneous lumbar discectomy.
    Next, I had to get a letter of medical neccessity from my doctor saying that a Percutaneous lumbar discectomy
    (medical code 62287) was needed for my condition and that I met all the criteria stated above. I recommend you getting that from your doctor and you will have a much better chance of getting approved. It took me about 4-6 weeks for the approval process.

    Just a FYI - I am starting a new post to ask all former nucleoplasty patients how they are doing now and their experience. I hope you'll write and let me know!

    Here's hoping you get approved !

    ken

     
    Old 10-19-2003, 03:14 PM   #11
    gharari
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    Thanks Kenneth. Good advice. I have read the CPB's several times too. I am in the process of getting supporting letters from my doctors and then I am going to send in my package to Aetna.

    The CPB doesn't make sense that they would not cover a nucleoplasty if they state that they cover percutaneous Disc Decompression. That's what a nucleoplasty is. Anyway, thanks and wish me luck with this dumb ins company.
    __________________
    -28 year old male
    -6'0" 195 pounds
    -5 years chronic pain in lower back
    -Done PT, 2 epidurals, and NSAIDs
    -MRI shows herniation in L5-S1
    -diskogram confirmed diskogenic pain in L5-S1 and L4-L5
    -had numerous doctor's opinons regarding Fusion, microdiskectomy, nucleoplasty, and IDET.
    -M.D.'s: Michael Wolff - Physiatrist, Dennis Crandall - Orthopedic Surgeon, Curtis Dickman - Neurosurgeon, Anthony Yeung - Orthopedic Surgeon
    -Considering IDET and or Nucleoplasty as recommended by Dr. Wolff
    -Leaning away from IDET due to it's longer recovery time.
    -Nucleoplasty treatment on L5-S1 and L4-L5 on 9/18/03

     
    Old 10-19-2003, 07:20 PM   #12
    Mary Anne9998
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    Hey guys-FYI, had a customer of mine from EBay that upon chatting works for Blue Cross and had to start working at home because of her back. Anyway she mailed me the information that BC started paying for the neucleoplasty. Now I don'thave Blue Cross insurance, but she said it is a good sign that other insurance companies would soon follow once they found out the "big" company is approving it. Might mention that to yours and see if they check it out. I have the copies if you would like to have them, although not sure how we would do that. But let me know, it might help

     
    Old 09-05-2004, 09:43 AM   #13
    gharari
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    Re: Successstory and other nucleoplasty patients: How was your recovery?

    My insurance company (Aetna) finally caved, 6 months later, and reimbursed me for my nucleoplasty. Good thing.
    __________________
    -28 year old male
    -6'0" 195 pounds
    -5 years chronic pain in lower back
    -Done PT, 2 epidurals, and NSAIDs
    -MRI shows herniation in L5-S1
    -diskogram confirmed diskogenic pain in L5-S1 and L4-L5
    -had numerous doctor's opinons regarding Fusion, microdiskectomy, nucleoplasty, and IDET.
    -M.D.'s: Michael Wolff - Physiatrist, Dennis Crandall - Orthopedic Surgeon, Curtis Dickman - Neurosurgeon, Anthony Yeung - Orthopedic Surgeon
    -Considering IDET and or Nucleoplasty as recommended by Dr. Wolff
    -Leaning away from IDET due to it's longer recovery time.
    -Nucleoplasty treatment on L5-S1 and L4-L5 on 9/18/03

     
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