Broke my back and need HELP.....

Have you spoken with a financial counselor at the hospital and discussed your eligibility for Title 19 (Medicaid) or other assistance program? If you're already 100% disabled, on SSI, and on Medicare then the co-pays you're describing seem exceedingly high unless your family income exceeds your eligibility for T-19. Even then the financial counselor can work out payment plans.
The question of owning two airplanes while living on government subsidies raises its own moral and ethical questions, if this is the case.


I had a life before I became disabled. Should I be living in a box?
 
I had a life before I became disabled. Should I be living in a box?

I was just raising the question. There are probably a lot of libertarians on this board who would ask the same question. I personally believe that we in society have an ethical and moral obligation to help others in need, and to help provide the basic elements of food, shelter, and medical care.

If the heart surgeon is simply planning on doing a dacron graft on the outside of your aorta you are indeed lucky. However, if your aortic valve needs replacement, then they need to put you on bypass, or if they're going to do a graft inside your aorta you would also likely need to go on pump.

The need to do the valve or not is determined by how well it is working (or not). The main terminology phrases are ejection fraction (how much of the blood is making it through the valve (>50% is great, less is worse), the valvular area in cm2, and the pressure gradient across the valve. These would have been determined by your echocardiogram. You should have open access to this information.

If the valve is replaced, the surgeon would have to decide between cow or pig valve (finite lifetime but no need for anticoagulation) versus a mechanical valve (requires lifelong coumadin usually, and regular blood tests). Generally, younger people get mechanical valves.

They would likely then have to reattach your coronary arteries to the graft, and these are the big arteries that supply blood to your heart (and blockage causes heart attacks).

You might want to be asking the cardiac surgeon the exact plan prior to surgery. If your BP is low and it is due to the heart valve and not some other cause such as medications, then it certainly sounds like your valve is not working well and might warrant replacement based upon the results of your echo.

Regarding your back, it still looked like your problem would be addressed by a single level decompression and fusion. This is fairly commonly done, but is also fairly extensive. A disk replacement, given your age and the limited films you supplied, would not be the right operation. Multi level disk replacements have never been considered an acceptable alternative.

BTW- discograms have really fallen out of favor, for the very reasons you describe. You have no recourse against the surgeon, but might want to consider whether this is a person you would consider operating on your back.


Finally, with your cardiac issues, no reasonable spine surgeon would or should remotely be considering an elective operation on your back- the risks would be too great. However, once your cardiac issues are addressed and stable, you would have to decide whether the risks of a fairly extensive back surgery would be worth the chance of eliminating your back pain.

The key is to be sure to ask the right questions when you see your docs, so if you write them down and bring them with you it would be a lot better than thinking of them after the visit.
 
This was before I had the engine upgraded to 40hp. She runs so much better today. Way more power.

this is a video a buddy took with his GoPro.

https://www.youtube.com/watch?v=7i-cw8vBNUo

Tony

P.S. I have no idea why I can not insert video's. I give up on that.

Embedding Youtube videos is as easy as yt and /yt tags, with the part after v= in it. For this example:

(yt)7i-cw8vBNUo(/yt)

Replace the parenths with brackets :yes:
 
I was just raising the question. There are probably a lot of libertarians on this board who would ask the same question. I personally believe that we in society have an ethical and moral obligation to help others in need, and to help provide the basic elements of food, shelter, and medical care.

If the heart surgeon is simply planning on doing a dacron graft on the outside of your aorta you are indeed lucky. However, if your aortic valve needs replacement, then they need to put you on bypass, or if they're going to do a graft inside your aorta you would also likely need to go on pump.

The need to do the valve or not is determined by how well it is working (or not). The main terminology phrases are ejection fraction (how much of the blood is making it through the valve (>50% is great, less is worse), the valvular area in cm2, and the pressure gradient across the valve. These would have been determined by your echocardiogram. You should have open access to this information.

If the valve is replaced, the surgeon would have to decide between cow or pig valve (finite lifetime but no need for anticoagulation) versus a mechanical valve (requires lifelong coumadin usually, and regular blood tests). Generally, younger people get mechanical valves.

They would likely then have to reattach your coronary arteries to the graft, and these are the big arteries that supply blood to your heart (and blockage causes heart attacks).

You might want to be asking the cardiac surgeon the exact plan prior to surgery. If your BP is low and it is due to the heart valve and not some other cause such as medications, then it certainly sounds like your valve is not working well and might warrant replacement based upon the results of your echo.

Regarding your back, it still looked like your problem would be addressed by a single level decompression and fusion. This is fairly commonly done, but is also fairly extensive. A disk replacement, given your age and the limited films you supplied, would not be the right operation. Multi level disk replacements have never been considered an acceptable alternative.

BTW- discograms have really fallen out of favor, for the very reasons you describe. You have no recourse against the surgeon, but might want to consider whether this is a person you would consider operating on your back.


Finally, with your cardiac issues, no reasonable spine surgeon would or should remotely be considering an elective operation on your back- the risks would be too great. However, once your cardiac issues are addressed and stable, you would have to decide whether the risks of a fairly extensive back surgery would be worth the chance of eliminating your back pain.

The key is to be sure to ask the right questions when you see your docs, so if you write them down and bring them with you it would be a lot better than thinking of them after the visit.


I would really like to thank you from the bottom of my heart for this advice. We have had some conversations back and fourth. It may not show but I do thank you.

I do not blame the man who did my discogram. He was a very very nice man. During the operation he kept saying how he did not like doing these and was so very sorry he had to do it. Its the guy who order this to be done I have a problem with. He needs to stop doing this to people in the condition such as myself. Now if he did not have the understanding or education to know that this type of operation on a person such as myself, is not good. Then he needs to be held for malpractice. He should have known better. My doctor I have today has told me this more then 4 times. Every time this comes up he shakes his head and says, he has no idea why anyone would do a discogram on someone in my condition.

You know ignorance is bliss. I never felt my chest hurt like it does. I always thought it was back pain in my upper back. Today I feel its in my chest, my chest burns sometimes it hurts. At first I thought it was in my head. They tell me my heart is having problems and now I start feeling things in my chest. But no, I am having issue's. The burning feels like a warm cup of coffee. We all have done it, drank our coffee to fast and the chest gets warm. I have this feeling most all day. Sometimes it eases. Other times its really prevalent.

Crazy how this has changed so much. I do know having people to talk with has helped. I thank everyone.

The hardest thing I have found is knowing what to ask. I saw the test results from that echo heart thing but had no idea what i was looking at. I am sure the cardiologist will go over it with me. He is another very nice man. I must say I have come across some very carrying people. I will write down some of the points you hit on.


Thanks again everyone. What a crazy ride its been. I believe that is lyrics in a song...lol

Tony

P.S. I am on only one medication for my back. Its an anti-inflammatory. I have had low pulse all my life. When in the hospital in my early thirties, the nurse taking my blood pressure asked me if I was still alive. I had a pulse of 26 BPM. I told her others have complained about my low pulse and not to worry about it. She said she was getting ready to call some code, I forgot what it was. I just laughed. She said she has never spoken with a person that has a heart beat as slow as mine. I was on some heavy pain medicine. I had a bone infection.
 
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Its been about a year now that the wife put a bottle of tums on my night table. I get heart burn in the middle of the night so bad it wakes me up. Now today we understand why. I just thought I was eating wrong or something I ate.
 
No, you could have reflux.It may or may not be related to your heart at all.
 
No, you could have reflux.It may or may not be related to your heart at all.


It could be a number of things. Crazy thing about our bodies. I have had shooting pains going down my left arm. It was from my neck. These pains down my left arm started happening again and they say its from my back. My left hand has gone numb or the finger tips have. This started after that discogram. But it could be other things causing this.

The general public " Me included " have the mind set a head ache is just a plain head ache, and it could be, but it could also be something much worse. Our bodies are not simple. I have a new found respect for the medical field and those who choose to practice in it.

Tony
 
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I should say i have always had a respect for those who practice medicine. Its the cost of this that i have a problem with. But this is another story. But we all know our health care system is broken and it has nothing to do with who is setting in the white house. This system has been broken for decades. Its about profits and not about people. But again this is above the doctors heads.

Good example, on my last doctors visit. Doctor tells me in order for the insurance to pay for the open heart surgery I need, we must do another test. A genetics test. They want this to show that this is indeed a life threatening case. Really, my aorta is swollen to 4 cm and they need a test that cost 1000 bucks to show I need this surgery. Not only that I have to fork over 200 bucks. If they want the dam# thing let them pay for it.

But this is another war that I just do not have the energy to fight.

If I am wrong for feeling or thinking this way please set me straight. I have an open mind and will listen. Maybe I am just stupid. But this just does not seem right to me. This is not about the doctor. This is about the insurance companies and billing. To me anyway.

Tony
 
Ok lets set something straight. I just got off the phone with the Dr. office about this Genetics test. This is NOT being done to satisfy insurance. Boy did I have that screwed up. This is being done to indeed confirm to the doctor about my condition and some other info.

I have got more things wrong over this entire thread then I have got right. Why I make my wife go on every doctors visit. I get information overload when it comes to doctors.

I wanted to set this straight. I am probably wrong about the billing and charging too...lol
 
I am not understanding how you can be on SSI and yet get a 20% copay. Have you spoken with the hospital billing office about this yet?
 
I am not understanding how you can be on SSI and yet get a 20% copay. Have you spoken with the hospital billing office about this yet?


I am not on SSI but SS. There is a difference between the two. SSI is for those who did not make enough to be covered by Social Security. I get SS not SSI.

I tried to get SSI they told me I made to much in each quarter or something like this.

Tony
 
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I am not understanding how you can be on SSI and yet get a 20% copay. Have you spoken with the hospital billing office about this yet?

The only way not to have coinsurance is if he also had state medicaid. Probably worth applying for once he uses up unprotected assets.
 
Or purchase a Medicare Type F supplement policy.


I did this. The only way the doctor would see me was if I got a supplement. This all started after I got this supplement. I had to wait almost one year to get all this going because of this. The doctor I saw was smart enough that once she saw I had on my records Marfan's she sent me to a cardiologist. No other doctor ever did this. I told every doctor who saw me that I had Marfans. They either did not believe me or just blew it off. All my life no one did anything about this. This is not right. I was ignored by our medical community. Its about time someone listened. I owe Dr. Tsang, because of her something is being done. God Bless her.

Tony
 
You have a Type F supplement and you still have co-pays? The lesser supplements have deductibles and co-pays but I've never seen a Type F supplement that did. I have my own Type F description of coverage (through AARP) in front of me right now, and in the list of scenarios, the last column "You Pay" is "$0" for every single line.
Since having Medicare and my Type F supplement, I've had MD visits, lab work, X-rays, and an MRI ... and haven't paid a dime out of pocket. I have a consultation with my neurosurgeon in three days and will not be surprised if he recommends a second c-spine laminectomy and fusion -- and, if he does, I expect to have no out of pocket expense for that. My supplemental insurance is not cheap but it is paying off well this year.
 
You have a Type F supplement and you still have co-pays? The lesser supplements have deductibles and co-pays but I've never seen a Type F supplement that did. I have my own Type F description of coverage (through AARP) in front of me right now, and in the list of scenarios, the last column "You Pay" is "$0" for every single line.
Since having Medicare and my Type F supplement, I've had MD visits, lab work, X-rays, and an MRI ... and haven't paid a dime out of pocket. I have a consultation with my neurosurgeon in three days and will not be surprised if he recommends a second c-spine laminectomy and fusion -- and, if he does, I expect to have no out of pocket expense for that. My supplemental insurance is not cheap but it is paying off well this year.

Yea I believe I don't have type F. Type F,D,A,C. I have no idea what I have. Its about as confusing as it can be. What i have pays 80% and I pY 20%. 25 dollar co-pay for regular doctor, 50 copay for specialist. I pay for the first 4 days in the hospital and the insurance pays 100% after that. We all know most hospital stays are less then 4 days. But I have been hospitalized for a few weeks at a time more times then I can remember. I purchased what the wife and I could afford. If we must go broke over my medical problems I will kill myself first. I will not let my wife be on the streets again. I will die first.

Tony
 
I also will not let us loose everything we own, been there and we did that. It will all come to an end first, I will see to it.

The other insurance or the one that pays everything cost hundred of dollars a month. If I remember correctly it was 300 bucks a month or there abouts.

It should not come down to do you buy food or pay for health care. Or do you pay rent or pay for health care.
 
I had great insurance until I became ill. Then I lost my job and lost my insurance.
 
I did work, held down a good job. Then I lost everything. Life became hell after that just fighting for health care. I lived on the streets for over a year. We lost everything we had pets and all.
I get very upset when I think about what the wife and I went through trying to fight my health. Now here we go again. I will not let it come to that. No Way.
 
So you might ask how does someone who has nothing end up here with a couple small EAB airplanes and playing in the play ground of the 1%.

Its because when you file for disability and you are indeed disabled. They go back so many years and back pay you. They only go back 3 years in 99% of the cases. But when the judge read my case, it made her so upset she went back from the day I became ill. She went back ten years. That was eight years ago this happened. That was when the wife and I got off the streets 2007. I found aviation in 2009 and soloed at the end of that year.

My very first flight.

https://www.youtube.com/watch?v=m8v8VWP8Pjo

Tony
 
You have a Type F supplement and you still have co-pays? The lesser supplements have deductibles and co-pays but I've never seen a Type F supplement that did. I have my own Type F description of coverage (through AARP) in front of me right now, and in the list of scenarios, the last column "You Pay" is "$0" for every single line.
Since having Medicare and my Type F supplement, I've had MD visits, lab work, X-rays, and an MRI ... and haven't paid a dime out of pocket. I have a consultation with my neurosurgeon in three days and will not be surprised if he recommends a second c-spine laminectomy and fusion -- and, if he does, I expect to have no out of pocket expense for that. My supplemental insurance is not cheap but it is paying off well this year.

Yea I believe I don't have type F. Type F,D,A,C. I have no idea what I have. Its about as confusing as it can be. What i have pays 80% and I pY 20%. 25 dollar co-pay for regular doctor, 50 copay for specialist. I pay for the first 4 days in the hospital and the insurance pays 100% after that. We all know most hospital stays are less then 4 days. But I have been hospitalized for a few weeks at a time more times then I can remember. I purchased what the wife and I could afford. If we must go broke over my medical problems I will kill myself first. I will not let my wife be on the streets again. I will die first.

Tony

There are plenty of places that have Medicare info classes. Most are geared towards seniors. They explain the differences in coverage and supplements and aren't there to sell you anything. It sounds like you could use some help understanding not only what you have, but what other options are out there - bring copies of whatever coverage plans you currently have. Instead jumping forward to killing yourself, check with your local county senior services agency for referrals. You might be letting too many people, from too many offices tell you what they think you have, instead of educating yourself. Take your wife with you, or send her if you can't travel.
 
I believe it is a medicare advantage plan.

Probably, since he still referenced the 20% co-pay (the same as for straight Medicare). When I replied to your post about eliminating co-pays and deductibles by having Medicaid, I stated one could also do that with a Type F supplement. Tony then replied, "I did that." My point (worded as a question) was that, no, he didn't.
There are (at least) ten different flavors of Medigap insurance. Type C and Type F are the most comprehensive and, of course, the most expensive. Type F is the more comprehensive of the two; it also provides coverage of Medicare Part B excess charges.
I am somewhat surprised at Tony's statement that he looked at other supplements and "the one that pays everything" cost $300/month. While I realize there are regional differences in rates, I pay only $125/month for my Type F supplement. It could just be he is mistaken about that.
 
So you might ask how does someone who has nothing end up here with a couple small EAB airplanes and playing in the play ground of the 1%.

Its because when you file for disability and you are indeed disabled. They go back so many years and back pay you. They only go back 3 years in 99% of the cases. But when the judge read my case, it made her so upset she went back from the day I became ill. She went back ten years. That was eight years ago this happened. That was when the wife and I got off the streets 2007. I found aviation in 2009 and soloed at the end of that year.

My very first flight.

https://www.youtube.com/watch?v=m8v8VWP8Pjo

Tony


Why would you file for disability 10 years after you became ill?
Why would you file 1 day after?
 
All the twists and turns in Medi ... make my head spin. I feel sorry for those with limited comprehension trying to figure it out.
Probably, since he still referenced the 20% co-pay (the same as for straight Medicare). When I replied to your post about eliminating co-pays and deductibles by having Medicaid, I stated one could also do that with a Type F supplement. Tony then replied, "I did that." My point (worded as a question) was that, no, he didn't.
There are (at least) ten different flavors of Medigap insurance. Type C and Type F are the most comprehensive and, of course, the most expensive. Type F is the more comprehensive of the two; it also provides coverage of Medicare Part B excess charges.
I am somewhat surprised at Tony's statement that he looked at other supplements and "the one that pays everything" cost $300/month. While I realize there are regional differences in rates, I pay only $125/month for my Type F supplement. It could just be he is mistaken about that.
 
Why would you file for disability 10 years after you became ill?
Why would you file 1 day after?

It took that long to get it. I filed as soon as I could not work. That is a complete different story in its self.

The judge who had my case, she was very upset with the system because of what happened to not only me but my family. I tell you it was horror.

It was 8 years not 10.

Tony
 
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Probably, since he still referenced the 20% co-pay (the same as for straight Medicare). When I replied to your post about eliminating co-pays and deductibles by having Medicaid, I stated one could also do that with a Type F supplement. Tony then replied, "I did that." My point (worded as a question) was that, no, he didn't.

Also with a supplement, there are no issues with a 'network'. The great majority of spine surgeons accept fee for service medicare. Medigap plans have to pay all charges approved by medicare and can't insist on use of their network. There are of course differences in the A-N policies in what deductibles they cover, but I have never encountered fixed co-pays with any of them.
I can't remember ever seeing a 'medicare advantage + medicaid' situation, I am sure they exist. With the medicare advantage plans, we usually only deal with the HMO.
 
Also with a supplement, there are no issues with a 'network'. The great majority of spine surgeons accept fee for service medicare. Medigap plans have to pay all charges approved by medicare and can't insist on use of their network. There are of course differences in the A-N policies in what deductibles they cover, but I have never encountered fixed co-pays with any of them.
I can't remember ever seeing a 'medicare advantage + medicaid' situation, I am sure they exist. With the medicare advantage plans, we usually only deal with the HMO.


When every doctor or nurse see's my insurance card they say they have never seen this insurance before. The Marfan's doctor's nurse called the number on the back of the card while I was in the office. She wanted to see what they covered. She told me what I posted.
 
There are of course differences in the A-N policies in what deductibles they cover, but I have never encountered fixed co-pays with any of them.
A Type N plan comes the closest to that. It will cover 100% of the Medicare Part B co-insurance except "up to" $20 co-payment for office visits & $50 co-pay for ER visits. The percentage part of the equation is such that the $20 is really a fixed amount -- unless there is still some physician out there charging less than $100 for an office visit. The other lesser plans are based on percentages (e.g. 50% for K policies and 75% for M policies).
 
Found out today my heart rate at rest is down to 40 BPM. They are putting a pace maker in. All I know so far. They are doing this in a week.
 
I had a Cat scan of my heart. They used the contrasting die when doing this. The cardiologist called to speak with me, but would not tell me anything for my wife was not with me. He is calling today at 11 am. Here we go again.

Just great.

Tony
 
I had a Cat scan of my heart. They used the contrasting die when doing this. The cardiologist called to speak with me, but would not tell me anything for my wife was not with me. He is calling today at 11 am. Here we go again.

Just great.

Tony
I'll be holding my breath until 11am with you Tony and hoping for the best.
Good luck.
Keep us posted.
 
The news was not bad news. The doctor told us that my aorta has not grown any larger since my last scan. It looks as the operation to wrap the aorta can wait until this winter. I have many more doctor appointments just in the next two weeks, but this is good news. The wife and I have been on cloud 9. We are so happy this was not bad news.

He is putting me on Beta Blockers. I have no idea what those are but have an appointment with my primary doctor Tuesday and she is going over all this with me.

I will keep everyone updated as I learn more. Thanks again to those who care.

Tony
 
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Saw my Primary doctor today. She tells me I have a nodule on my left lung and one on my thyroid. The one on the thyroid is 9 cm. She did not say how big the one on my lung is. I had more x-rays and blood work.
To think this all started with a bad back. Myself I believe all this is nothing. We will see, for what do I know.

Tony
 
Don't worry about the thyroid. Benign nodules are common, and you're way past the age that thyroid cancer typically appears.

I had one that was 25 mm...a 1" ball on my thyroid, had no idea it was there.
 
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Saw my Primary doctor today. She tells me I have a nodule on my left lung and one on my thyroid. The one on the thyroid is 9 cm. She did not say how big the one on my lung is. I had more x-rays and blood work.
To think this all started with a bad back. Myself I believe all this is nothing. We will see, for what do I know.

Tony

Dont get too worked up about that. Thyroid nodules are common and the majority are benign. I would assume that it is 9mm rather than 9cm (3.5in).

Same with lung nodules, most of them are benign. You mentioned that your aorta hasn't grown, this implies that you had prior imaging. If you did have a prior CT scan of the chest, the first step is to pull that study and to have it compared to the current one.
 
Dont get too worked up about that. Thyroid nodules are common and the majority are benign. I would assume that it is 9mm rather than 9cm (3.5in).

Same with lung nodules, most of them are benign. You mentioned that your aorta hasn't grown, this implies that you had prior imaging. If you did have a prior CT scan of the chest, the first step is to pull that study and to have it compared to the current one.


You are so correct. It is 9mm not 9cm. I am still waiting on the results from the chest x-ray. I did see it and the complete left lung was white in the x-ray.

You know I am not worrying about any of this. If it is anything bad, I am not sure I want anything done about any of it. Just let the chips fall where they will. The worst part is watching all the bills pile up. I told the wife to not worry about those either. I will file bankruptcy if I must. I have never done this in all my years but will over this. No way to pay all the bills coming in with what the wife and I make.

The hospital called the other day wanting money. I told them if I live through this and I believe I will, I will just file bankruptcy, and if I don't, will I have no idea what to tell them.

The lady was very kind and did not get an attitude. She said when it comes to medical bills they can get overwhelming very fast. She was very nice.

Tony

P.S. I used the wrong wording. I should not have said my aorta has grown to this size. What I was told was its swollen to this size. No I have never had a scan of this before. I also found its 3.5cm in size not 4cm. If it gets to 4cm they will open me up. They want to check it again in a year. Again thank you for posting this.
 
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