Vertebroplasty Round 2: The Plan

We met with our Dr. Chen this morning and skipped straight to the Flouroscope.  Satomi’s newly reinforced back made her lying on the scope table less painful so it was a low-stress visit.

It was very interesting-On the screen I could see the nickel-sized chunks of cement in her T12, L1, and L2 vertebrae.  Her chop-stick-poke wounds are closed over and healing well.  The local pain has also decreased  

The doctor poked and pressed and a few minutes later, we had a plan:  L5, T10, and T11.  L3 and L4 had no obvious damage and there was no pain.  This does violate the 3-in-a-row requirement but the lumbar vertebrae are about 50% larger than most others so their strength is not compromised.  The repair of her T10 and T11 vertebrae are a continuation of the original repair.

There will definitely be a 3rd vertebroplasty session sometime in February to address T7, T8, and T9.  T9 actually has no obvious damage but it is a small bone and will likely be crushed by the repaired vertebrae above and below.

We confirmed that all her pre-op tests were recent enough not needing to be repeated.

[1/20/10 Update:  The procedure is set for 7:00am Monday January 25th.  Hopefully it will go better than the first time.]

[1/22/10 Update:  The hospital just called.  Our insurance sent the claim on the original Vertebroplasty procedure to Medical review.  That’s done when there is a question about the medical necessity of a procedure.  All future procedures must have pre-approval.  So the procedure has been delayed for what could be weeks.  After many upset phone calls I tracked down the insurance department at City of Hope and expressed by dissatisfaction.  While I understand that this may have been due to Blue Cross Blue Shield, why didn’t they call before 3:30pm on the Friday before the procedure?  It was too late for me to call the BCBS offices and raise hell.  Satomi is disappointed and upset and I’m Level 10 pissed off].

[1/25/10 Update:  I spoke with BCBS this morning.  They said the medical review had been completed and approved; payment on the original claim was in-process and our policy DID NOT REQUIRE PRE-APPROVAL FOR PROCEDURES.  It was what I expected.  I called the City of Hope with BCBS record numbers and names of personnel that document the discussion.  The City of Hope people took my info and asked to call me back.  After about an hour, they called and indicated that all is well and the procedure will be resecheduled shortly.  I reminded them that there will be a third procedure in the next month or so, “…now that we worked out all the bugs, I’m sure next month will go smoothly…”  I’m not going to hold my breath.]

[1/26/10 Update:  City of Hope hadn’t called yet so I left them a message.  I got a call a couple of hours later with a new procedure date:  Monday February 1st at 9:00am.  Here we go again.]