Four-way Truss Rod...in Titanium

[ConnemaraGuitar]

Hello, friends. I'm becoming a bit desperate so I thought I'd seek assistance from the experts.

I was scheduled to have a "do over" of my spinal fusion surgery last week. You see, last April a very nice neurosurgeon spent 8 hours fusing five of my lumber vertebrae using bone grafts and four pair of titanium rods. The rods are attached to each of the five vertebrae using 2 inch screws. The screws look like #8s to me.

Alas, six months after surgery things started going amiss. After a bunch of xrays and CT scans, it turns out that four of the screws (one pair each at the top and bottom vertebrae) failed to hold, which caused the bone grafts to fail. After offering numerous suggestions, such as using match sticks inserted into the screw holes to give better purchase, the surgeon said he wants to go in and replace the whole mess.

This was scheduled for last Tuesday, but on Monday my insurance company refused to authorize the procedure. Darn! I was really looking forward to two months of recuperation while not working. Not to mention all the drugs that turn me into more of an idiot than I already am!

The insurance company's reasons for refusing to pay are total BS, and I'm going through a formal appeal process. It's all so terribly wrong. Meanwhile I'm exploring alternatives.

After looking at all the xrays and such, I've decided what I need is to have a 4-way truss rod implanted in my spine. I'm not sure why it should be 4-way instead of the standard 2-way, but hey, why mess around? Oh, and it needs to be titanium. I figure that since it will be four-way, adjustment screws will have to be at the top and bottom. Top for anterior adjustments (for relief) and bottom for lateral (to adjust for twist).

Here's where you folks can help out: I've checked all my luthier supply catalogs and can't find 4-way truss rods in any of them, much less in titanium. Can any of you steer me in the right direction?

Also, I'll need a really good luthier to install the darned thing. I know Tom's folks are the best out there, but I hate to ask since he has so many other things going on right now. Since there are no f holes required...well, I can hint, can't I?

Any assistance or advice would be appreciated! Thanks!

[tom]

how about two two way rods set at 90 degree angles to each other? everyone knows your back won't sound as good with 2 way rods in there though.

[mdrs]

Lofton, make sure that they use vintage titanium, for better sustain.

:cool:

In all seriousness, back problems can be tough. Hang in there. Insurance companies are HORRIBLE. I wish I could say that I was surprised that they yanked your coverage the day before your surgery. I wouldn't do that to my worst enemy. They are bastards, and simply don't care about anything except keeping your money in their pockets.

I'm sure it'll all work out for you. Good Karma headed your ways!!

[Briggs]

I like Tom's idea but i'm not adjusting that bottom screw, you're on your own for that one!

prayers for you and the doctors and that the ins co gets their act together!

[dannopelli]

You know, I think you can do this truss rod procedure without surgery. I am sure you realize that the butt bone's connected to the back-bone...

Of course if you do it this way, those folks that say, "Hey that Lofton guy really seems to have a stick up his a_ _," will finally be telling the truth!

[getgo]

Lofton, After all I've been going through since October with my lower back re-injury, your thread had me in tears! Maybe it's all the meds I'm on! :D Just the funniest thing I have read in a while and there is not a lot I laugh at lately. Thanks again for your thread and most of all your great attitude with a painful and often desperate situation. I wish and pray nothing but the best for you and your inevitable recovery.

[ConnemaraGuitar]

Thanks to everyone for their suggestions and good thoughts. I set up the "Karma Katcher" on my roof the other day and my poor wife has had to climb up there four times already to empty it. I just hope she doesn't fall!

Tom, I'm going to have my surgeon give you a call. He wants to know how to program his CNC machine to cut the slot for the truss rods. He also needs you to explain the whole "neck relief" thingy. Go figure!

BTW, the insurance company doesn't realize who they're messing with. I haven't located their Forum yet but once I do and show them some of my posts from this site I'm sure they'll come to their senses.

Maybe tomorrow I'll put up pics of my current hardware...it'll be a variation on some of the more recent NGD posts. Roy might even see fit to add them to the GOTW page! His write-up is bound to be a hoot.

[dannopelli]

In all seriousness:

We all hope and pray for the best for you. Bad enough that you have to face another painful operation and recovery. Dealing with a recalcitrant insurance company on top of all that is no joy.

Good Luck!

[Roy (maybe)]

Your truss rod analogy amuses me, and so does your smile in the face of this. Of course we are with you and will assist you in the instillation (note spelling) of your new truss rod—what a great idea.

Through my life I have seen healing that never ceases to astound me. Out of a situation of “no way” and “it can’t be done,” a healing will happen that will change everything and bring your physical body back to peace. It happens everyday. Doctors see it but since they cannot control it or administer it they don’t usually list it as one of your options—rightly so from there position.

I did have dealings with a doctor in a life and death situation who did say that 50% of the healing would depend on the patient and family and how they were. What he meant was, if we don’t get assistance from more than the amazing medical community, we are dead. As a doctor he had seen it many times before, so he said it. And did we see everything change for the better in the face of what seemed truly impossible? YES! Over and over again. Even insurance company attitudes melted—so wild. Today all is happy and healthy. The key may have been that we had come to the end of our knowledge and our trying and it was simply not enough. There was no place else to go. There was only one path left and we took it. We had to release everything to: how we all know life should really be—love, peace, joy and health. And one day at a time it began to change—not so much fighting but flowing.

You can tell by all the well wishes you have already received that we are all behind you being your best. Feel it now, and everyday. Whether the insurance company initially says, yes or no, you are in good hands now.

[ConnemaraGuitar]

Roy (Maybe), I can't tell you how touched I am by your post. Thank you for the strength of your words and the power of your insights. And vice versa. I'll sleep better tonight.

I believe that healing in all forms is possible only through hope; despair ultimately robs us of our power to heal and be healed. For me, humor is the bridge from despair to hope. Plus, it's just funny (sometimes).

Thank you, my friend!

Now, about that truss rod "instillation"...

[ConnemaraGuitar]

So it's almost a month since my last appearance on this thread, and here's an update.

My formal appeal for authorization of surgery was denied by the insurance company a couple of weeks ago, so I decided to see if I could sort out the confusion. I asked the surgeon's office to mail me the documents which had been submitted in the original and follow-up submissions to the insurance company.

When I looked at what had been submitted from the surgeon's office all became clear: I don't need surgery at all! I'm as fit and healthy as any other 30ish 58-year old. No mention of pain or falling down stairs. No problem with basic body functions (about which I will not elaborate). Almost-normal reflexes. I had no idea things were so good.

I'd love to meet (and be) the person described in my medical record!

So revisions have been made. Medical records are revised and surgery is now scheduled for April 3. Per my surgeon, the procedure will either be elective (if the insurance company authorizes it) or emergency (if they don't). I definitely qualify for the latter, in case some of you are wondering.

At the end of the day, I have to say the delays had positive outcomes. I met an anesthesiologist who will keep the hallucinations away after my surgery. My attitude is better, I think. I'm scared and don't want to go through this ever again. The fear has forced me to seek strength and comfort from the "powers that be".

To quote that famous literary figure, Alfred E. Neuman:

"What? Me worry?"

And so far as the original topic for this thread...well...never mind!

Sincere Thanks and warm regards to all.

Lofton

PS There has been yet another silver lining to this dark cloud, but I'll hold off on sharing until the dust settles.

[mdrs]

Loften, I'm sorry that you had to go through all that insurance company "red tape".

As a physician, and a surgeon, I sometimes wonder what has become of a society where those that make the rules put the rules over the individuals we're supposed to be helping.

Your persistancy will pay off. Being scared is normal. As a physician, I'd be worried if you weren't scared!!

One step at a time. Best wishes for a complete and steady recovery!!

[dannopelli]

All the best Bro. We are all pulling for you.

[ConnemaraGuitar]

Thank you, Don. I appreciate your kind words and support. You too, Danno. You guys are the best.

I just typed a long diatribe about the basis for my current situation, but will instead hit the "delete" key and move on.

Will update as necessary, if amusing. Otherwise, assume the best. And please send good thoughts towards my wife...she's a treasure!

Lofton

[Roy (maybe)]

Lofton,

So if you step back now and take a look, all is working out well - just as you had hoped for last time we talked. You have been guided and taken care of with more and better still to come. There is no reason that you will not continue to heal and be well and feel better and better. When you see yourself start to worry say, "Yes," to healing and health and wholeness and let it flow in that direction with your mind continually welcoming that state of being. It will ease you and your body will follow.

Man, isn't it great being a musician...we can all talk this way and know what it means...it all surfaced through music in the 60's with Peace and Love and has never stopped.

We all know you are on your way now, healing, health and well being...why not? So it is for you now.

Best to you.

[ConnemaraGuitar]

Hello, all. Just a quick update on my long-hoped-for back surgery:

Since the end of January my insurance company has maintained that my surgery lacked "medical necessity." This was really confusing to me since I seemed to clearly meet all the requirements specified in the "medical necessity" documentation. But I missed one: unless one year has passed since the last surgery, medical necessity does not exist for a subsequent procedure.

On April 13, which was 371 days after my first surgery, I was approved for a second procedure.

Tomorow, April 25th, is my big day for getting that new four-way titanium truss rod. Thanks to everyone for your support and I'll give a shout when I'm able.

Warm regards,
Lofton

[Roy (maybe)]

Hi Lofton,

Great news. Now relax and breathe into new health, mobility and vitality.

Blessings
Roy (maybe - or not maybe)

[csd]

Ditto on that Lofton and best wishes.

Hi Lofton,

Great news. Now relax and breathe into new health, mobility and vitality.

Blessings
Roy (maybe - or not maybe)

[dplight]

That is good news. Best of luck.

[Briggs]

prayers for you, your family, and the doctors!

[dannopelli]

Good luck sir. We'll be praying for you...

[ConnemaraGuitar]

So here we are, almost a month since my last post. My wife is telling me I need to "get out" more, so here I am!

On April 25th I arrived at the hospital at 0530 to get prepped for my surgery. Although I was supposed to be the first case, someone jumped the queue so I didn't head for the operating room until 0900 or thereabouts. After speaking with seemingly tens of folks, anesthesiologists, surgeons, electro physiologists, etc., I got wheeled into the OR. Wow! It was a huge room lined with flat-screen monitors and all sorts of fancy equipment. And, more surprisingly, there were windows! I've never seen an operating room with windows, and the light was amazing. And I could have sworn that I saw at least three Dr Z amps.

Then I must have dozed off (with the assistance of some chemical agent), and a few hours later I woke up in the recovery room, feeling pretty good. The surgeon then came in and informed me that when he made the incision to start removing all the old hardware, he saw what he believed to be evidence of extensive infection, and way more scar tissue than he anticipated. So guess what? They cleaned out the yucky stuff and sent it to the lab for analysis, and stitched me up.

Two days later I went home with what's called a PICC line (peripherally inserted central catheter) in my left bicep and orders for 6-8 weeks of intravenous antibiotics. After this, the surgery can be re-scheduled if the infectious disease specialists approve.

The schmooey (that's a medical term) removed from my incision never produced any evidence of infection...namely, the cultures were all negative. There was also no evidence of any infection (normal temperature, blood counts normal) physiologically. But the die was cast.

Aside from the presumed infection, the surgeon has also decided to use a different approach for fixing my defective spine. This time he's going to install hardware on both the front and the back of my spine to hold things in place. This is a more extensive procedure that the back-only approach, the details of which I won't share. I suspect this was the main reason he terminated the surgery when he did, which is likely a good thing.

So, for the past month I've been sitting around the house doing nothing other than infusing antibiotics into myself and reading eBooks. The dog really hates the IV pole for some reason but the cats are intrigued by the tubing. Shoo, Kitty! My inactivity forced me to quit messing with the biological filter on my koi pond so it’s had a chance to do its job; the pond is crystal clear and the koi are uglier than ever.

My wife has been an absolute gem through all of this. Every time I start doing something I shouldn’t, she makes me sit down and then does it herself. When all is said and done, I’m hoping my next surgery will be the last and by fall I can get back to a normal life. I REALLY look forward to mowing the lawn and taking out the garbage!

Thanks for letting me ramble!

[RVA]

Your rambling is quite uplifting. I will pray for your speedy recovery and hope it does as much for you as your story did to inspire me on what I previously considered a difficult day.

All the best brother.

[mdrs]

Wow, what a journey you've had, Lofton!! Keep your spirits up, and your thoughts positive.

Now, if you could figure out a way for the IV pole to feed the dog, I'd bet he'd like the IV pole a whole lot better........

:cool:

[ConnemaraGuitar]

Hello, all,

The plan was to post an update when I had pictures but that ain't gonna happen for a while yet.

Thanks to all the good kharma coming my way from you gracious people, I finally had my "revised" back surgery on July 18 in Philadelphia. After all that had come before, it was an almost anti-climactic event. I had two surgeons and a slew of others present to make sure the CNC machine was set up right and to keep sawdust off the floor. I may have mentioned this before but the neurosurgery operating room has floor-to-ceiling windows on three walls. The day was bright and sunny and I felt that all would be well. And it was.

The surgery involved fusing the bottom 7 vertebra of my spine (from the back) using titanuim hardware and bone grafts. The bottom three vertebrae were fused from the front as well (hence two surgeons). I now have excellent posture and an impressive (but unknown) scrap value.

Unlike the last time, I progressed quickly through the recovery room, intensive care room and my regular room; I even had a "window bed" after the first night, and was sent home after only 4 nights. As of yesterday it's been 5 weeks.

I believe most of you can relate to this: when I woke up the morning after surgery I had an overwhelming sense that all had gone well. I even "remembered" the sunlight. On Saturday I shared this with my neurosurgeon and, after giving me a funny look, said that yes, the procedure had gone far more smoothly than he had expected. Cool stuff, eh?

The healing process is going well, and my bride is taking amazing care of me. I have no trouble sleeping, which is really great. We finally figured out a pain management strategy that leaves me sane and only a little bit loopy.

I didn't know this the first time around but it turns out that nicotine (in any form) is really bad for bone grafts and spinal fusion outcomes. So I quit smoking...for the first time in 45 years. Darn, I sure miss all that coughing!

I also found out that there are electronic stimulation devices that promote bone healing, so I have this really cool looking belt that transmits an electro-magnetic current through my midsection for an hour every day. There's no sensation from the device and sometimes I wonder if it's just a gimmick, but I am diligently compliant.

In a couple of weeks I should be fit enough to go back to work, and I'm excited about that.

So anyway, that's the status from Narberth. All is well and I appreciate the discraction of visiting the forum periodically. I sure would like to see some pics of the new facility, though...hint, hint!

[dplight]

That's really great news. Hope that things continue going well.

[Briggs]

That's fantastic! I love the attitude and how you've kept your sense of humor throughout this whole process.

[dannopelli]

Really happy for you Lofton. Finally one went your way!

[mdrs]

O.K., Lofton, good posture is fine and all. But, I'd NOT undersell your scrap value one bit, Brother!! When times are tough, ya gotta go with what you got!!

;)

Break a leg......er, make that very happy to hear that you are well, and progressing steadily.....and most important that YOU are happy.

:cool:

[Pietro]

"scrap value"... hee hee...

best to have a sense of humor when all is not well. Praying you recover FAST.