need surgery, will it be subcontracted?

[skippy13]

I need to have C5-6-7 (maybe C-4 too)fusion and live in VISN 21 area. Can I be subcontracted to a "local" VAMC for this? Oregon Health Sciences University attached to the VAMC are the only ones who have provided all of my Neuro care so far. Is this correct procedure? This is one time I dont want the lowest bidder:D

I have no one to help me after this procedure is done, how to get temp help at home?

[SCI-Nurse]

There is an extensive list of surgical procedures for Veterans with SCI that must be done only at VA SCI Centers (Seattle for you), and spinal surgery is on that list, so the first step would be for your Spoke Clinic in Portland to contact the Seattle SCI Center to see if this is a procedure that they do. I would be very surprised if they are not quite expert in this area.

If that is not possible, then is may be possible for your provider at the Portland Spoke clinic to submit a request for fee-basis care. This would not be provided if this is a service already available within your VA or a referral center (such as Seattle). This is only for the specified care, but you have a choice of where you go to get it (as long as they will accept the fee-basis conditions). It would be best first to get an estimate of the entire costs (physician, hospitalization, anesthesia, etc. etc. etc.) first so your provider knows how much the fee-basis request would be for. Fee basis approvals are good for only 3 months. It is likely they would require you to return to the VA post-operatively for your recovery, and then your SCI Spoke Clinic team and the VA discharge planner would also need to help you arrange any home health or other home care you would need during your recovery. It is likely that this would need to be covered by your Medicare or other insurance, since home health care is not usually a VA covered benefit.

(KLD)

[skippy13]

I dont need to worry about finding anyone to help me after this procedure. I am being dumped into a pain clinic. They want to give me trigger point injections so that I cannot feel my arm die.

I had EMG studies that clearly showed an impingement on C-7 and was told that I needed surgery. What kind of crap is this? I'm going to start going to Medicare for all of my stuff because I'm not getting what I need from the VA.

They want to teach me how to live with the pain instead of fixing it. I know how to live with pain, I've been doing it since 1990. I'm tired. I dont want to keep on with this stuff. I won't do it this way anymore. I just wont.

[SCI-Nurse]

Once again, they need to you to Seattle to the VA SCI Center. Don't do ANYTHING (including injections) before you do this. Did you talk to your PVA NSO? To the SCI Coordinator in Portland? You should not be getting SCI specific care at a CBOC!

(KLD)

[Mona~on~wheels]

Skippy please check out what you need and don't give up sweetie.
What seems unbelieveable today may not be so tomorrow.
Please let us help. There's alot of brains here to work this out honey.
Please? We care so much for you. ((((HUGS))))

[skippy13]

The pain clinic didn't want to do trigger point injections because they say it is too dangerous for me.

The surgeons (2 of them @ Portland and Oregon Health Sciences) say they wont operate because it is too dangerous.

Q: Give up and let it be and slowly lose all function, or try to find someone through medicare? Either way I'm pretty well screwed and it will only continue to get worse. What to do, please?

[SCI-Nurse]

Again, you need to go to your SCI Center in Seattle for a complete evaluation, which would include this issue. That is what they exist for.

(KLD)

[skippy13]

the VA is no longer an option. Should I pursue this surgery further or let it be?

[Coleen]

Skippy - PM me, please.
There's surgeons in Seattle that might be able to help you - I know it's a long trip, but it might be worth it.

[Veteran Advisor]

the VA is no longer an option. Should I pursue this surgery further or let it be?

Anytime one discusses spinal surgery, the only piece of advice I'm qualified to offer is ensure you've given full and informed (written) consent after being counseled on the risks of any proposed procedure. You should also be thoroughly counseled on the risks of not doing surgery. Once you understand the pros and cons of your choices, you and only you must make what has to be a very tough decision.

As far as clinical care systems go, I'm not sure why VA is not an option for you, but it couldn't hurt to fully exhaust the resources available in the VA's SCI care system before exploring private sector options.