Hello Everyone,

Can you imagine, there have been 423 views of this thread. That is amazing.

Now I invite all "standing on the sidelines" to become active participants in the sharing of questions as well as information. And don't feel it must be restricted to "lasers". For enable all to make the best decisions we must know and understand other options.

RichT

Hello Everyone,

Below is an E-Mail I received from Dragonfly (Susan).

Thanks Rich,
I've not been able to sign up yet - having trouble with the sign up and
need to come up with a new user name. Plus now in the process of settling
with Chiu/CA Spine Inst.. He makes LSI look cheap! He charged $59K for his
Laser Surgery once all totaled and I think he got flagged by my Insurance
company. My Lawyer is trying to work with the Lien and get me something
from my small car accident settlement - also small because it was brought
out his problems doing the surgery. I'm contacting the Attorney General in
CA - soon since he now sent a Form Type Letter stating patients with Liens
pay up regardless of outcome or insurance or settlements. So, looks like
common practice for him.
Grrr, having a bad flare up during all this making computer work very
painful.
Thanks you so much for keeping me in the loop. I'll be catching up as soon
as possible.
Dragonfly44 or ??? new persona. : )

As you can tell she is having her "challenges" with the CA Spine Institute. I hope things can be settled to her satisfaction without due delay.

RichT

Hi everyone! I'm back in Tampa today and it feels great to be home! As it stands my second surgery is scheduled for Aug. 28th, but there's a possiblilty they'll be able to get me in next week. I'll find out Monday for sure.

RichT, Joebob, LSG, Susan, Carol, and everyone,

Thanks so much for all of your support! I appreciate it more than I can express! It really helps to know that we all genuinely care for eachother's healing! Rich, you're doing such a wonderful job of accepting everyone on this thread and I thank you for that!!!

Now that I'm at my own computer now, I'll give you a little more on my surgery. As I mentioned earlier I had a discectomy, laminotomy, foramenotomy, and a partial facetectomy at L5/S1 on the left side. Dr. Bonati said my case was "unique." Apparently, the gel-like material from within the disc that leaked out when it herniated actually attached itself to the nerve and the nerve was wrapped around and not in the proper location. He said he was really worried getting that close to the nerve because I'm female and he thought I'd give him a hard time (aka crying, kicking and screaming). That's when the good Lord held my hand and allowed me to lay still!! I felt it, that's for sure, but God kept me still! Dr. Bonati said once he was able to remove the material from my nerve, my nerve popped right back into place like a rubber band. So fascinating!!!

I'm off for another walk! I've been doing 45 minutes/day since the day after my surgery!

Best wishes to you all and God bless you in your recoveries!!
Carrianne

Hello Carrianne,

Your post gives me that warm wonderful feeling inside.

You and the good Lord surpised Dr Bonati for sure. AND because of that he was able to perform your surgery much better than even he thought possible. I only hope that I can do as well as you did.

The fact that you can tell us in amazing detail about your "unique" situation and the nerve being wrapped around the material that leaked from the herniated disc tells me that Dr Bonati SHARES and INFORMS his patients very VERY WELL.

Carrianne, if it wasn't for the insurance issue with Bonati Institute I wouldn't even look elsewhere. Oh how I wish they took Medicare patients.

I hope you enjoyed your walk.

My grandson and I have been enjoying building a model rocket together. We are having a "blast".

Look forward to your wonderful and informative updates.

Enjoy your day!

RichT

We went to LSI on Friday for the second visit. LSI really needs help with scheduling. 9:00am appointment, but didn't get in again for 2 1/2 hours. Waiting at Dr's offices really bugs me!

anyhow, we met with Dr. Rothman to review my MRI's and X-Rays. He determined that I definitely need fixed at L4-5 and a good possibility of needing fixed at L5-S1. This was the same diagnosis that Dr. Tolli had. We finished all our meetings with all the departments by 1:00 and my wife and I retreated to the lunch room to discuss options.

I am really not sure that we made the correct decision, but we decided to have the work done at LSI rather than by Dr. Tolli. The main reasons were: outpatient vs. 2 days hospital stay, local vs. general anesthesia (we were guessing that Tolli uses general), and probably less invasive (not really sure about this either). On the other hand, Dr. Tolli does two levels at once and is covered by BC/BS. Very tough decision.

I am a little concerned that they are operating on the wrong disk, which I expressed this to Dr. Rothman... In the exam office, they had a chart of which areas of the body are affected by which lumbar regions. It seemed to me that my pain areas were coming from the L5-S1 rather than the L4-5, which is really in much worse shape. Dr. Rothman was sure it was coming from L4-5. We shall see.

In posts on some forum, someone was questioning how LSI removes bone vs. soft tissue. The answer is they use a diamond burr on bone and the laser on soft tissue. They will be using both on me.

At LSI, I pressed very hard for a guestimate of how much we would get back from BC/BS of FL. The best answer I could get was anywhere from $5000 to the full $30,000 deposit. They were not about to be nailed down to any narrower range. A second surgery on another level will require a deposit of $25,500. While Dr. Rothman consulted with me, he may or may not be the one who operates. I requested Dr. St. Louis or Dr. Wolff and was informed that Dr. St. Louis will be out of town. I really don't like not meeting the Dr. who would be doing the surgery. In my mind, this is another big negative to their assembly line approach to surgery. They mentioned that they currently do around 300 surgeries per month, which will soon be increasing to 400 and they are opening a center in Arizona. As mentioned by other posts, everyone was very nice and not is a rush.

My surgery is scheduled for this Thursday 8/23. I'll let you know how it goes.

Guy

Guy....We all wish you good luck with your 8/23 laser surgery. I guess I didn't realize they could schedule you so soon. Anyway, I know you researched everything and weighed your options carefully before settling on LSI.

The financial options scare all of us I think, so thanks for giving us a ballpark figure. And don't second-guess your decision about LSI because it looks like any of them would work. I think I would ask again about the wrong disc before they operate though.

We'll talk with you soon and thanks for the update.

LSG

Hello Guy,

Thanks so very much for your great post and the information and detail you provided. It really helps those of us considering spine surgery.

This is the third time around in trying to send you a post. I'm going to make a MS word copy on this one. LOL Not sure what I did that was wrong.

For impatient me, I'll wait a max of 45 minutes before I start questioning the receptionist as to why it is taking so long. Okay, if the doctor is in surgery and something unexpected came up, I surely would want the doctor to do the surgery right rather then rush things. However, twice that happened to you. Must say that makes me concerned.

"(we were guessing that Tolli uses general)" - Guy, may I suggest that you contact Dr. Tolli and find out if he plans to use a general anesthetic or a local. And if a general, then why. "Assuming" is not a good idea from my experience.

"probably less invasive (not really sure about this either)" - Perhaps it would be a good idea to ask both Dr. Tolli and LSI the length of the incision and WHY they would make the length of incision that they plan to make.

Also, may I suggest that you get a fairly firm idea of what the total costs will be from both Dr. Tolli and LSI. Fair better to know now rather than wish you had after the surgery.

Guy, I don't want to create undo concerns for you, however, in my opinion far better to get those unanswered questions answered before any surgery.

If after the questions have been answered, and you still feel LSI is the best place to go, then GO FOR IT!!!!

My thoughts and prayers are and will be with you.

RichT

RichT & LSG:
Thanks for your inputs. I can be really persistent with asking questions, but it is hard to get any really meaningful answers. I asked Dr. Tolli about LSI and how his procedures are different from theirs. His only answer was that I should check his results and how happy his patients are. He did not say anything of substance that would influence my decision and he did not say anything negative about LSI. I described what I know of Dr. Tolli's procedures to LSI and asked what they do different. The only answer I could get back was that LSI's procedures are the state of the art, results in negligible scar tissue, and are the most minimally invasive. It would be nice to get the two doctors on stage in a debate, but that's not likely. So, in the end, I don't know how a lay person can make an informed decision. And, I don't know how I would determine, in fact, who as the best results and who is the least invasive. LSI has you start on PT the next day, while Tolli waits 3 weeks. Maybe that's the answer, or maybe Tolli is just being more cautious?? I did call a number of LSI's references and had a personal friend recommend them from their own experience.

Regarding cost comments: I think we would be out-of-pocket at least $6000, maybe a little more, with Dr. Tolli who is in the BC/BS network (75% pay). I am guessing that the maximum that I will be out of packet with LSI (per surgery) is $15,000 and hopefully less than $10,000. We are fortunate that with that difference in cost, we can focus on getting the best results rather than spending the least money. Unfortunately, however, it is still not an obvious decision.

I think I will call Dr. Tolli's office on Monday and ask if he uses General or local anesthesia. I assumed General because you are in the hospital two days - but I could be wrong.

LSG: I will ask again on the day of surgery about the wrong disk. Both Dr.s agreed on the L4-5 disk, so that is probably the correct one and their office nerve chart may not be entirely accurate.

Regarding LSI's 2.5 hour wait time: I did ask at the desk several times, but you have to realize that there are about 40 people (sometimes more) in the waiting area and the receptionist would only give vague answers about when I might get called. At lunch time when I asked, she did say that I could go down to the cafe and they would call me.

Also, considering that LSI services mainly physically challenged and elderly people, their facility is not particularly friendly to people with disabilities. I got dropped off at the front door by my wife, who then tried for about 10-15 minutes to find a parking place in their overcrowded 3 story parking garage with no elevator. I walked up about 8 steps, (I don't recall a ramp) to the very heavy glass doors which are not easy to open and have no automatic opener. I can only walk a very short distance before having to sit, so I was immediately looking for a place to sit in the lobby, but there was nowhere to sit. There is a cafe on one side of the lobby and a PT center on the other side, both of which are also behind very heavy glass doors which are hard to open and do not have automatic openers. The reception area is on the 4th floor, which I found out about by asking in the PT center and thankfully they had an elevator to get up there. Frankly, with all the laws today about providing for disabled people, I am surprised that their facility isn't illegal. My wife, by the way, has tendonitus of the hips and had a very painful walk down the 3 flights of stairs in the detached parking garage and then through the walkway to the main building. My sister, a nurse, said that with that type of facilities, at the very minimum, they should offer attendant parking service.

Well, I am rambling on after a few glasses of wine. I should be watching the Bucs game. In spite of the criticisms, we still selected LSI and surgery is still planed for Thursday.

Guy

Hi everyone. Just wanted to drop a line and wish you all a good night's sleep! I know how difficult that can be so I hope we all fall asleep fast and don't wake up until morning!!

Best wishes and God bless you all!
Carrianne

AbraCadabra,
Have you checked out The Bonati Institute? I know you've already scheduled appointments at LSI and I'm certainly not trying to waive your decision (they're ALL performing miracles daily), but bonati does honor out-of-network benefits so all you're responsible for financially is your deductible plus your out-of-network out-of-pocket maximum. Just a thought. I know the financing is a hurdle so thought I'd share just in case you weren't already aware.

I so wish, RichT, that they would accept Medicare and perhaps one day they will!!! With God, all things are possible!! You're certainly on your way, my friend!! God bless you!

Thanks Carrianne. Getting to sleep can be a real trial sometimes, especially after the rocking Saturday nights we have around here!!

Seriously, are you improving daily as you look forward to the 28th? Are able to walk without pain for long distances yet?

I talked with my wife today about the laser surgery and I was able to use all the info from you and all the others on this thread. Unfortunately, we are planning a move back to Texas and that means we won't be settled for another few months.

Thanks again and toodleloo.

Lonestar

Hello,
I just discovered this forum and so glad to find that I'm not alone in my frustration and confusion. Three months ago my back problems escalated to where I had to stop working. Since that time I have had two MRI's, a myelogram, a discogram, and a catscan. The findings were degenerative disc disease, bulge/hernaition, and foraminal narrowing at L3/4 L4/5 L5/S1 with Facet Disease in L5/S1. Reccomendation from my neurologist... double fusion. Visited a spinal pain management clinic and all they could suggest as an alternative to surgery was a morphine implant. No thanks to that. This is when I started looking at laser surgery which as you all know sounds far superior to the open back surgery and all that it entails. I contacted LSI who said I was a candidate, but my insurance company BC/BS of S. Carolina said no way to any compensation whatsoever. Time is running out as my short term disability ends in three months and the recovery time for fusion surgery is at least that. I want to thank all of you for your informative posts and sharing your experiences. If anyone has any hints or advice on insurance at Bonati's or Microspine or anywhere else, I would greatly appreciate it. Without substantial coverage, I will have to go through with other. I wish all of you the best.

Hello GatorD,

Welcome to this thread and all who post here.

Sorry to read about your back pain. I truly hope you can find the solution that is best for you.

It is very frustrating when ones insurance will not cover the procedure one wishes. And as I found out from Bonati, because I have Medicare, they (Bonati) won't take me as a patient even though I have a secondary insurance company.

May I ask where you live? That may help others give you some options.

You, I and many others look at fusion as the last option.

You mention the foraminal narrowing - Have you had an epidural injection to reduce the inflamation? I had an epidural and it has at least helped me to function. No cure of course, but it has worked for me and at least delays the surgery.

RichT

Hi RichT,

Thank you for responding, this is a difficult situation but there must be an answer and solution for all of us.

I have been under the care of one of the best, if not the best, neurosurgions in Jacksonville for three months and even he is not crazy about the double fusion surgery. I'm running out of time though and have an appointment on the 30th to disuss details and going forward with it because I can't seem to get anywhere with the alternative laser surgery.

I have tried the injections, medications and all the pain management to no avail. I can't understand why BC/BS of SC doesn't pay for LSI or similar procedures, which are far less expensive and sounds like they could be more successful than spending five days in a hospital not to mention the lenghty recovery and no guarantees. I simply don't get it.

I will call Bonatti and Microspine first thing in the morning, that is assuming I can roll out of bed or my girlfriend doesn't shoot me first to put me out of "our" misery.

It is very cool there is a forum like this so that we can inform each other and hopefully find a way to overcome and have a life again.

Thank You, Donald

Hello Donald,

Just for clarification - Did your BC/BS say NO payment to LSI, or was it NO payment for the procedures they use? If they refuse to deal with LSI, then perhaps they may work with Bonati or MicroSpine. Just a thought. This whole medical treatment/insurance issue is a real pain.

To me it boils down to the insurance companies thinking of ways NOT to pay for this or that medical treatment so they keep more money in their pockets. It surely isn't because this is "experimental treatment" because the laser procedures, etc. have been used in the U.S. for over 10 years. In fact, one of the laser procedures has been approved by the FDA.

Forward -

I'm very glad that you have an excellent neurosurgeon. It is essential that one have confidence in the doctor you are working with. There are a number of "types" of fusion procedures. From the traditional "open" back surgery, to the less invasive micro techniques. And then there are various devices that are available. Some place I read where there is a fusion technique that is "flexible". As you proceed, I would be most interested to know the details if you would be so willing to share.

Let me know what you find out at Bonati and MicroSpine.

Tomorrow I meet with my PM doc. I have my questions ready for him.

Just make sure you roll out of bed on the right side. LOL

RichT

guy

good luck with the surgery and i hope it all goes well!!!!!!

Welcome to the forum. MicroSpine says they honor BC/BS Allowables and they are "near" you in the Panhandle. Their Dr. was with Bonati in the beginning and that is about all I know.

I was impressed by Dr. Tolli in St. Pete, who does laser surgery, but probably not quite the same as LSI. From what I can tell, he has a very good reputation and he is in the BC/BS network.

Best of luck.

Thanks for the reply. Yes, I checked into Bonati Institute. I did not go there, but I did speak with them and seriously considered going there. In the end, after I started with LSI, the cloud of law suits hanginging over Bonati discouraged me. Also, there must have been some reason why the Docs from Bonati left and formed LSI and MicroSpine??? I know people on this forum have had success at Bonati and based on that, I would say it is probably a great place. I am from the computer industry where we had the saying "You can tell the pioneers... they are the ones with the arrows in thir backs." (As in the early american pioneers and indians). Anyhow, Bonati may have been the pioneer and took all the arrows???
I hope all is still going well with you.

Guy

Suzy (The Girlfriend) - Welcome to this forum and thank you for your kind wishes to Guy.

Guy you provided Donald with very good thoughts.

Guy, I hope all goes well with your upcoming surgery at LSI. My thoughts and prayers are and will be with you.

Everyone posting here is really adding to the "life" of this thread. We are learning from each other.

Everyone, have a GOOD Day!

RichT

Hello Guy,

This thread is really on a roll this evening. GREAT!

Whoops what do you know about lawsuite hanging over Bonati that I don't know about? Tell me more. I spoke with someone from the Florida Attorney General's office just last week. The only malpractice fillings against Bonati were in the 90"s at the time the "other" doctors were with him. Most fillings were dismissed by the courts. To my knowledge there has not been anything of a legal nature with Bonati since '02. Has there been something recently?

RichT

Abracadabra,

It's great that you're doing your research on both places. It all boils down to you making the decision you feel the most comfortable with. Trust your gut and best wishes to you! God bless,
Carrianne