Well, apparently it is an expensive surgery... if covered insurance pays 80% and I pay 20%. My 20% is $7,500 which means the whole thing is $37,500! And to top it off the out of network surgeon I want is willing to do it pro bono and not charge me the extra! The in network of course would charge as normal. And I have absolutely no extra money in savings right now that isn't being used to pay all my bills and co-pays. (out of network costs $230 per visit!)

It is probably more than that since the insurance company will decide that "customary and ordinary fees" are much less. My guess is that they will knock 25%+/- off the charge pay 80% after deductible. You end-up paying about 50%.

So you're good to go with the out of network guy and it won't cost you anything if I'm reading this right? That's great news.

Good to go with the out of network guy as soon as I can get him approved by blue cross. They are telling me that there is a in newtork surgeon that does the same procedure, so we just got it in writing from that in network surgeon that they don't do the same minimally invasive procedure and there is a decent difference in healing time etc. So today we are resending the authorization request to blue cross with everything in writing from the other doctors office etc. Fongers crossed!

And I really hope they just approve the damn thing because the cortizone epidural already wore off as of yesterday and I really hate having to take narcotic pain pills every 3 to 4 hours just to keep the pain at a somewhat tolerable level as it is pretty damn bad right now. (getting worse, not better)

Do whatever you have to do to get it covered. Many people forget to consider surgical complications, which do arise. I certainly hope that everything goes 1000% perfect for you, but should anything arise, just a single day in a Neurosurgical ICU will cost you more than a few thousand dollars. Don't even think about risking it. Also minimally invasive is the way to go, your recovery time will be like night and day compared to the open procedure.

Did you get a second opinion?

I ask this for a few reasons- (first, this is not medical advice.)

You have a degradation of the cervical spine at several motions segments. (I've never heard of 'hemoraging discs'...discs have no blood supply.... wonder why you were told this.) But this degradation is leading to nerve root compression- the foraminotomy will just remove the bony processes that are- along with bulging discs or reduced disc height- compressing the nerve- but will not eliminate the structural issues. As this degradation progresses, you have things like instability, spondylolithesis (vertebral bodies not in alignment) that can occur ....which will mean fusion time.

Make sure you are getting a global assessment that balances the current symptoms, future possibilities and all the risks.

Good luck

A

I wasn't thinking right when I typed in hemorrhaged, meant herniated... It is the herniated portion of disc that is causing the nerve root compression. The foraminotomy is to get me relieved of the debilitating pain and muscle strength degradation caused by the pinched nerve without going as extreme an operation as a 3 level fusion. Although I may need to go that route years later in the future, now is not the right time in my life for that major an operation. At this point I really don't have the amount of insurance coverage needed or ability to take that long off from working without better short term disability coverage than I currently have. So the good doc is in agreement that the foraminotomy is the best choice at this time, and the minimally invasive procedure he performs with the arthroscopic type procedure will require the least amount of healing time. I don't anticipate a spondylolisthesis type problem, know I will be much more aware of what affects things I do will have on my cervical spine. (I am always really careful with my lower back) And I also plan on doing activities like canoeing/kayaking much more often to build more of a muscle base in that area for support, as I'm not really one who goes to the gym so I find activities like that to keep myself in shape somewhat. I just hope there is progress soon with all the insurance bullshit... I will feel so much better after it is at least scheduled.

Well, 2 months to the day after the onset of the symptoms I finally had my surgery, and it was a success. They kept me in the hospital overnight for observation and I got home today around 2pm. Now I just know I'm gonna wake up in lots of pain tomorrow when all the numbing agents etc. fully wear off at the operation site and I get to feel all the bruised muscles, inflammation and scar tissue!

But now I can actually begin healing and move on with life! Next stop, new kayaks! :woohoo:

Good luck with recovery. Best wishes. Keep us updated. And prayers go out to you.:thumbup:

Wow, you have had a pretty tough 12 months or so. Take care man, really sorry to hear it.