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Back surgery at VA

Guess I’d have to say look to your VA and see what kind med professionals they have access too, the Durham VA shares a lot of common ground with Duke Medical Center and seem to have a lot of good ones that hang out there on a regular basis. I am putting off knees, but that because I just don’t want to have any more surgeries until it is absolutely needed. IF your VA seems to suck all around, I second the care in the community program and use the doc of your choice. If I understand correctly, the last time I was waiting on the VA to look at something, it was a long wait. My choice was to wait or get out on the care in the community list, which would bump me from the VA doc waiting list. Not necessarily a bad thing in some cases but once again, it all boils down to the quality of your individual VA.
 
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What do we know about it gents.
I just got the call, I have an appointment w neurology for precursor to surgery.
Exactly what/where is your problem? Cervical? Thoracic (rare), or Lower? I've got issues in neck and lower back. I'd really get a second or even third opinion before undergoing the knife. Don't be scared of flying to another state to get a second opinion. Just make sure you have the MRI results and that they are good pictures (now it seems you may need software to build the 3-d picture as they are usually slices which make it harder for common folk to read). If the MRI tech didn't do a good job of making sure they shot in line with the spine they may be bad pictures (I lived next to a tech and she looked at mine and was like...this person didn't know what they were doing).

I have not had surgery...Close at times, but every single doctor I've had said...LAST RESORT. Almost everybody I've talked to that has had spine surgery has another, and another - very dependent on where on the spine the surgery is though and if it's a bulged, herniated or dead disk. I suspect my C5-C7 will be my first (thanks to this damn computer).
 
Exactly what/where is your problem? Cervical? Thoracic (rare), or Lower? I've got issues in neck and lower back. I'd really get a second or even third opinion before undergoing the knife. Don't be scared of flying to another state to get a second opinion. Just make sure you have the MRI results and that they are good pictures (now it seems you may need software to build the 3-d picture as they are usually slices which make it harder for common folk to read). If the MRI tech didn't do a good job of making sure they shot in line with the spine they may be bad pictures (I lived next to a tech and she looked at mine and was like...this person didn't know what they were doing).

I have not had surgery...Close at times, but every single doctor I've had said...LAST RESORT. Almost everybody I've talked to that has had spine surgery has another, and another - very dependent on where on the spine the surgery is though and if it's a bulged, herniated or dead disk. I suspect my C5-C7 will be my first (thanks to this damn computer).
I was active duty last year when I had my C3-T1 taken out, replaced and fused. It was done by a civilian surgeon, thank god.

I had my MRI done in Germany with the 3d technology. Thank god those docs know what they were doing.

When I got back here to Fort Carson, the radiologist said there was nothing wrong with me. Go figure, right.

Luckily the old provider I worked for put in an off post civilian referral amd got me taken care of.

Doc
 
Exactly what/where is your problem? Cervical? Thoracic (rare), or Lower? I've got issues in neck and lower back. I'd really get a second or even third opinion before undergoing the knife. Don't be scared of flying to another state to get a second opinion. Just make sure you have the MRI results and that they are good pictures (now it seems you may need software to build the 3-d picture as they are usually slices which make it harder for common folk to read). If the MRI tech didn't do a good job of making sure they shot in line with the spine they may be bad pictures (I lived next to a tech and she looked at mine and was like...this person didn't know what they were doing).

I have not had surgery...Close at times, but every single doctor I've had said...LAST RESORT. Almost everybody I've talked to that has had spine surgery has another, and another - very dependent on where on the spine the surgery is though and if it's a bulged, herniated or dead disk. I suspect my C5-C7 will be my first (thanks to this damn computer).
from the T12 to S1...they used the word severe from the L2-L3 to the L5-S1. more than a few things fuckered up in there.
 
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how does this work???
is it as simple as myself requesting it or am i entitled to this care if they cant fix me
Its used if the VA hospital does not offer a specialty service in house and also with scheduling and distance to your closest VA facility. Definitely throw that word around. Most of our providers love it since it allows them to free up scheduling and takes the burden of narcotics off of them and to an outside provider. Basically, you start by telling your VA primary provider you are interested in the "Community Care Program" The put in a consult to the Community Care MSAs that check for qualifications and then gets with Optum ( the middle man that handles scheduling and reimbursement) to set you up an appointment with who you'd like to go to. The consult is good for a year and can be renewed as long as you check in with your VA for routine check ups. the Outside Doc faxes or e-scribes the prescription to the VA and then we get it out to you.

Now, the outside providers MUST adhere to the VA formulary of drugs. Lots and lots of outside providers think its an easy way to get some free hook ups from Drug Reps and like to try and rip off the VA by writing those top tier brand new drugs. This certainly delays things and is what I get yelled at by out nation's finest every day. Docs can write what they want, but that does not mean your gonna get it. The BS part is that to be enrolled in the Community care program, these same providers sign on the line that they are going to play ball with our formulary. Does not mean you can never get those top tier drugs, just mean we got checks and balances like Blue Cross and Blue Shield does.

Any vets here interested please reach out to me with a PM. be glad to help in anyway I can.
 
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I sure hope you have exhausted all other possible treatments out there. I've had acupuncture ( just amazing ) in the past and now working with a chiro. My chiro is sort of a WAY too happy guy but his whole process has saved me from pain. I'd pay double for either the acupuncture or chiro over having surgery.

Surgery should be a last resort. $.02
 
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Its used if the VA hospital does not offer a specialty service in house and also with scheduling and distance to your closest VA facility. Definitely throw that word around. Most of our providers love it since it allows them to free up scheduling and takes the burden of narcotics off of them and to an outside provider. Basically, you start by telling your VA primary provider you are interested in the "Community Care Program" The put in a consult to the Community Care MSAs that check for qualifications and then gets with Optum ( the middle man that handles scheduling and reimbursement) to set you up an appointment with who you'd like to go to. The consult is good for a year and can be renewed as long as you check in with your VA for routine check ups. the Outside Doc faxes or e-scribes the prescription to the VA and then we get it out to you.

Now, the outside providers MUST adhere to the VA formulary of drugs. Lots and lots of outside providers think its an easy way to get some free hook ups from Drug Reps and like to try and rip off the VA by writing those top tier brand new drugs. This certainly delays things and is what I get yelled at by out nation's finest every day. Docs can write what they want, but that does not mean your gonna get it. The BS part is that to be enrolled in the Community care program, these same providers sign on the line that they are going to play ball with our formulary. Does not mean you can never get those top tier drugs, just mean we got checks and balances like Blue Cross and Blue Shield does.

Any vets here interested please reach out to me with a PM. be glad to help in anyway I can.
Thankyou
 
Do you have the Peacock app on your TV? If so, watch Dr. Death. It's a story about Dr. Christopher Duntsch and all his botched back surgeries. He's in prison now. My wife kept saying, "Do you think you should be watching this?" It was revealing.
Do you due diligence. Get opinions. It's important.

I waited 23 years to have an L5 S1 laminectomy with fusion which was done in November 2019.
When first diagnosed I saw three different surgeons. They all wanted to do it and interestingly enough they had three different ways to do it.

Anyway I managed it for all those years but got to the point where I had no choice. The vertebrae had moved to the point that some nerves were severely irritated, broke bones, etc. I have permanent nerve damage.

The surgery was not as successful as I wanted but I have a hyper-lordotic spine (i.e. excessive curve). A congenital defect.
I am better but not the outcome I wanted.

As for my neurosurgeon, he is one of the best in the business. This coming from other medical professionals that have worked with him.

Good luck!
 
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I sure hope you have exhausted all other possible treatments out there. I've had acupuncture ( just amazing ) in the past and now working with a chiro. My chiro is sort of a WAY too happy guy but his whole process has saved me from pain. I'd pay double for either the acupuncture or chiro over having surgery.

Surgery should be a last resort. $.02
I'm all for the avoid surgery at all cost......plenty of other remedies out there. How many great surgery stories do you hear? Not saying they don't work, but should be used as a last resort!
 
how does this work???
is it as simple as myself requesting it or am i entitled to this care if they cant fix me
I will add to what has already been said. The VA falls under the CHOICE ACT. Basically it states that if they cannot accommodate you for an appointment within 30 days and/or you live more than 50 miles away you can be sent out to community care. (CC). In reality it varies from VA to VA as some send damn near everything out into the community to free up provider slots, some VA's lack the specialists needed and are solely reliant on CC, and some are stingy as all hell with the CC funds and it takes a lot of noise to get sent out into community.

If they cannot get you into an appointment within 30 days you can demand community care. Once a consult it placed it goes thru a community care coordinator and that coordinator will call you and set up appointment with you and the needed specialist closest to your home of record. That is the time you ask for a certain one if you have a specific one in mind and have researched the civ docs in your area. They may or may not be under contract with the VA as only contracted medical doctors/offices can be utilized by the CC program. Make sure you have a couple of good civilian docs in mind you have already researched and know are worth a shit so you can request them when the coordinator calls you.

Community care is a double edges sword as some of the VA docs are damn good and some are terrible and some of the civilian contract docs are damn good and some suck ass. You need to find out the quality of your VA docs before jumping to CC. They vary from facility to facility. There are some cases where you would be better off staying with the VA doctor and other cases where you would not. Some of the contract docs send in secondary authorization requests attempting to pad the bill or add in unnecessary treatment because they just see a blank check from uncle Sam. Some of the contract docs do the shittiest work possible as its quantity over quality. But some of them are top of their game and will get you excellent, fast treatment for your needs. Basically research, research, research and ask all the questions you can think of.
 
What do we know about it gents.
I just got the call, I have an appointment w neurology for precursor to surgery.
I'm not sure what VA facility you'll be at. I use the Lake Nona VA hospital now for signigjcant procedures with the Daytona Beach clinic as my Primary Care facility. I am mostly satisfied with the care I have received. Prior to moving to Florida I had a major surgery performed at the VA hispital in Milwaukee, WI. They probably saved my life. Nothing is perfect and these VA facilities are "teaching" hospitals. But I think you'll be in good hands.

P. S. If you can get Community Care go for it! My wife (also a Veteran) has taken avail of that to get care at the hospital she works at or other local providers. It can't hurt to ask for it.
 
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They dropped my friend going from gurney to surgery table for back surgery. I'd say in 99% of cases go with a civ doctor unless you definitvely know va doc is phenomenal. My ortho guy was, others and current ortho not so much. I had words with my epidural idiot because she missed twice. I woke up in middle of hammer swing for patella tendon removal for my acl as a result of her incompetence. You get what you pay for lol.