Author Topic: SKull Base Possibility  (Read 53408 times)

chopper

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Re: SKull Base Possibility
« Reply #75 on: January 22, 2007, 02:28:42 pm »
i'm holding off the celebration for a month or so and keeping mye eyes out for some bills.

May want to wait a little longer.  I just got my second appeal letter to insurance back on Friday, denied of course.  So the process starts again I guess. 

Meanwhile I've gotten a collection notice from SBI for a bill that I never recieved.

Be wary of the bills too, the hospital tried to double charge on a lot of things and had the nerve to send me a bill for $4000.  Had them recheck their numbers and for some reason, haven't heard back since.
3+cm AN, hit the chopping block 5 Sep 06 at the Skull Base Institute

Was 4.5cm at it's largest point, completely removed.  All motor functions normal.  Only complaint is SSD on the left side, which was expected anyway.

ixta

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Re: SKull Base Possibility
« Reply #76 on: January 25, 2007, 02:51:29 am »
Coool chop, will keep the look out, i have an advocate in L.A. that is willing to go all over EOBs and bills to see if they are doing it right.
She gave one example of Doctors charging "reading fees", when a computer that does the actual reading, not a human. I hope she can bloodhound sniff around to see if there is anything fishy. I havent asked for the 11 grand deposit back yet from skullbase, gonna let it ride for a bit, see what creepy weeds grow in the garden, if any.
5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

sjwill

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Re: SKull Base Possibility
« Reply #77 on: February 01, 2007, 03:10:05 pm »

Chopper: interested to know why you are getting denied. sorry if I missed it earlier,
searched but didnt see anything. I'm about to send SBI 11K.... already in it for the $600
call. Like ixta, Blue Cross ins., but maybe different plan. Do I need to give them written
advance notice ? tia folks.
Diagnosed 10/03/2006
2.6cm, Grade 3, highly cystic.
Scheduled surgery at SBI March 12, 2007.
http://www.thestatus.com ID:90222060233
                                              PASSWORD: jingle-susitna

ixta

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Re: SKull Base Possibility WOOOHOOOOO
« Reply #78 on: February 04, 2007, 10:21:19 pm »
Ok the STORY HAS AN AWSOME ENDING!!

BLUE CROSS PREMERA HERITAGE PLUS ONE is my insurance I get through my employer.
I was assigned a Case Manager who advocated for me BIG TIME, and pushed for what is called a Benefit Level Exception, to get Shahinian as if a PPO.
So we were explained by SBI that we had to put down a 11 thousand deposit down before the surgery. They stated that if insurance did not cover the surgery, we would owe an estimated balance of 25 grand, of which the 11 grand deposit would go towards.

My insurance ended up paying the surgery which was around 60 grand, and insurance Also paid Brotman medical expenses which were like 150,000.
INsurance also paid some towards the 600 dollar preconsult meeting as can be seen in the letter. (they got the date wrong though. I had that in October)
I have received only one bill from the Brotman. 250 for an anesthesiologist, and 24 dollars for some med records I requested.
Still waiting for other bills, but if they don't come....ah shucks!
PROOF BELOW!!!!







WHOOHOOO :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D :D

5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

ceeceek

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Re: SKull Base Possibility question
« Reply #79 on: February 05, 2007, 04:40:09 pm »
Hey,

SO how did the surgery go...I am attempting to get info in regards to endoscopic surgery. There is actually someone in FL where I live who does it..and I am trying to compare cia nasal regular, or endo nasal...seeing that either way I need a biopsy..which sort of sucks as I was all set for CK, when Dr. Stated he really reallywanted a biopsy..well seeing where my tumor sits, when they perform a biopsy, they might as well remove said tumor....so after speaking ever so breifly with SBI, I was told to put on breaks, and compare proceedures seeing that the biopsy that more than likely will be performed on me would be a similar approach to transnasal approach and if they were doing that, they would more than likely take tumor...I could be good candidate for endo....Now of course, Moffit...(where I go Wed for one more official opinion) does not do endo....and they stated thier reasons why...I am trying to compare the two types..cause so far from what I have read, endo would definately seem to me the way to go....but I know there are differences,,,,,,,,,,,,Could you tell me how yours went etc....and why you chose that method???

Thanks
Ceeceek
Such is life...Finally identified...vidian nerve schwanomma, 2.8x2.8x3cm.....in the middle but under my brain.....post transphenoidal endoscopic surgery April 19th, 2007 Pre CK treatment in Sept 07.....re-arranged cavity in hopes of reducing side effects and now officially diagnosed as hard headed.

ixta

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Re: SKull Base Possibility
« Reply #80 on: February 06, 2007, 04:43:33 pm »
ceeceek...

One thing that I read about endoscopic surgery is that it can be very risky if there is a concern about nicking an artery which there may be in your case. The problem is that with such a small opening in the skull it is difficult to stop the bleeding in time if the worst should happen.

Bruce
The following is in regards to my Acoustic Neuroma Tumor that was growing from the vestibular nerve, and into the brain cavity area of the cerebelopontine angle.

 I asked this question specificaly during my pre op with Shahinian in his office. He mentioned it is a non issue due to how the endoscopic procedure is done in my case. and that those that question do not know the endoscopic process. ( Duh that's why I asked him *))

I felt it was a VERY important question to ask because I do not know about all the specialized tools he uses up their in my head that may or may not be used in case of "an artery" situation.

I know, and you can see in the video i posted, that a tumor is a living thing that is fed by numerous "arteries" and "capilaries", the instruments he uses core out the middle dead part first, then he carefully resects it off the facial and trigeminal nerves.

Of course, you can see how the tumor bleeds, but the tools he uses, actually eat at, and seals or suctions the blood at the same time.
you can see that in the video I posted. I think when we hear the term "its a bleeder"-all tumors bleed when they are resected. The endo tools used- deal with that perhaps. 

Perhaps he meant when he said bleeding is a "non issue" is due to the overall less invasive technique that therefore lowers the risk of bleeding overall inside the brain cavity.

Perhaps bleeding is more of a risk with the traditional method, where surgeons have gotten used to "controlling" them if it happens, and therefore always ask this question when someone asks them about endo.  I am not sure, and only a surgeon that knows both techniques should probably post. C'mon you Neurosurgeons We KNow your here! Post! hahahhaa :D

I think this question also gets into that "special recipe secret ingredient" area that endo surgeons have the answer to, but maybe it touches on the specific designs of the tools which engineers they contract with design and therefore it "is not in the open". I know they only use the instruments 1x, then they are in the garbage.
That's one reason why this route is soo expensive.
They are custom designing a ferrari to drive into your head, park there a while, then drive back out into the garbage can.

« Last Edit: February 06, 2007, 04:46:09 pm by ixta »
5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

ixta

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Re: SKull Base Possibility
« Reply #81 on: February 07, 2007, 04:35:32 pm »
yes that is to be determined. According to CEE, he is not sure what type of tumor it is.
I know my AN and most others grow into the brain cavity-the cerebellopontine angle,
It never was mentioned that my carotids were threatened.

I did some googling and came up with a differential Diagnosis writeup and they ruled out an AN in some research document @ Baylor
http://www.bcm.edu/neurol/challeng/pat62/summary.html


I copy and paste and highlight the topic that we are talking about.

Vestibular schwannomas, often known as "acoustic neuromas," typically arise from the vestibular portion of the eighth cranial nerve, and present with early hearing loss, tinnitus, and vertigo prior to invasion of the cerebello-pontine angle and involvement of other cranial nerves, such as V, VII and the IX-XI complex; involvement of cranial nerve VI is unusual. Schwannomas may be isointense to normal brain on unenhanced T1-weighted MR images, as in this patient, and may substantially enhance with gadolinium. Vestibular schwannomas in the cerebello-pontine angle typically manifest as round or ovoid masses, in contrast to the semilunar shape of meningiomas in this region. Many tumors of the cerebello-pontine angle can involve the internal auditory meatus, however, an enlarged internal auditory meatus is considered highly suggestive of vestibular schwannoma. On dye angiography, schwannomas are usually described as hypovascular, although occasionally schwannomas may exhibit substantial vascularity. Feeding vessels typically derive from the external carotid branches, with occasional contributions from branches of the vertebrobasilar system (7). Vascular supply from branches of the internal carotid artery would be extremely rare for vestibular schwannomas.

Again, the formal Dx has not been made yet, so CEE keep us curious posters posted!!
I remember seeing absolutely no carotid artery pumping in or near where my AN was located. If I did, I probably would've gone a cyberknife route of some sort. A+P people post!

I guess meningioma, pituitary or wild guess colesteoma?
5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

chopper

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Re: SKull Base Possibility WOOOHOOOOO
« Reply #82 on: February 10, 2007, 09:15:18 am »
Ok the STORY HAS AN AWSOME ENDING!!

BLUE CROSS PREMERA HERITAGE PLUS ONE is my insurance I get through my employer.
I was assigned a Case Manager who advocated for me BIG TIME, and pushed for what is called a Benefit Level Exception, to get Shahinian as if a PPO.
So we were explained by SBI that we had to put down a 11 thousand deposit down before the surgery. They stated that if insurance did not cover the surgery, we would owe an estimated balance of 25 grand, of which the 11 grand deposit would go towards.

My insurance ended up paying the surgery which was around 60 grand, and insurance Also paid Brotman medical expenses which were like 150,000.
INsurance also paid some towards the 600 dollar preconsult meeting as can be seen in the letter. (they got the date wrong though. I had that in October)
I have received only one bill from the Brotman. 250 for an anesthesiologist, and 24 dollars for some med records I requested.
Still waiting for other bills, but if they don't come....ah shucks!
PROOF BELOW!!!!

You sir....make me jealous.  Only paperwork I get these days is collection notices.  STILL fighting the insurance company.
3+cm AN, hit the chopping block 5 Sep 06 at the Skull Base Institute

Was 4.5cm at it's largest point, completely removed.  All motor functions normal.  Only complaint is SSD on the left side, which was expected anyway.

nannettesea

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Re: SKull Base Possibility
« Reply #83 on: February 11, 2007, 09:05:19 pm »
Ixta,
This was FABULOUS news regarding insurance payment.  I've already had surgery, but am not recovering, and am now suspect that my vestibular nerve took an alternate path to brainstem and it's still causing me trouble.

I'm considering going back in--yikes--but will demand the endoscopic approach.  HEI doesn't want to touch me due to what they will find--major scar tissue, etc.

Thanks for sharing the news.  My current insurance is the exact same plan as yours, and since you've paved the way, I might have a better chance.

Nan
1.7cm x 1.4cm x .8cm, right ear
Trans-lab approach
Dr. Jay Rubinstein, U of WA
8/29/05

jerseygirl

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Re: SKull Base Possibility
« Reply #84 on: February 11, 2007, 09:22:46 pm »
Nan,

Why do you need to have a second surgery and why wouldn't HEI touch you? They offered to remove my recurrance but I decided to go with endoscopic approach instead.

          Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

ixta

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Re: SKull Base Possibility
« Reply #85 on: February 23, 2007, 12:23:38 am »
Eve, please post a thread on your Endo experience when it starts. keep us in the loop, Good Luck! ;D
5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

jerseygirl

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Re: SKull Base Possibility
« Reply #86 on: February 23, 2007, 07:15:56 am »
Ixta,

I will post a thread on my endo experience but it will happen at the end of June. There is somebody on the forum who is going to have surgery there earlier and I begged him to do the same. This is so important! That is how I made up my mind, so undoubtedly it will help somebody else.

             Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

ixta

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Re: SKull Base Possibility
« Reply #87 on: February 23, 2007, 07:47:47 pm »
Ixta,

...............There is somebody on the forum who is going to have surgery there earlier and I begged him to do the same. This is so important! That is how I made up my mind, so undoubtedly it will help somebody else.

             Eve



Yes I think that person contacted me,

sjwill

He or she says he or she is having the preop 3/9 and the op a few days after.

Sjwill make a thread!
I think he or she mentioned he or she may be donig a Status.com page  too.  :)
5cm left AN from IAC to cerebellum/brainstem.
Zapped out by Shahinian @ SBI over the course of 6.5 hrs on Monday 11/27 2006.
thestatus.com   h   biologyfly06

ceeceek

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Re: SKull Base Possibility
« Reply #88 on: February 26, 2007, 04:48:52 pm »
Question for you guys in regards to SBI...how did it go with insurance..I have read some post, but because they are out of sequence it is a little hard to follow..trying to get idea in case I am not happy with conclusion from guy in Orlando....and just for your curiosity...Dr. Medbery finally got my films and says same thing as everyone else.....too funny
Ceecee
Such is life...Finally identified...vidian nerve schwanomma, 2.8x2.8x3cm.....in the middle but under my brain.....post transphenoidal endoscopic surgery April 19th, 2007 Pre CK treatment in Sept 07.....re-arranged cavity in hopes of reducing side effects and now officially diagnosed as hard headed.

sjwill

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Re: SKull Base Possibility
« Reply #89 on: February 27, 2007, 10:14:53 am »
Question for you guys in regards to SBI...how did it go with insurance..I have read some post, but because they are out of sequence it is a little hard to follow..trying to get idea in case I am not happy with conclusion from guy in Orlando....and just for your curiosity...Dr. Medbery finally got my films and says same thing as everyone else.....too funny
Ceecee

ixta and others on this board have been really great at posting their experiences with the insurance
and their efforts are deeply appreciated. I'll let you know how things progress with SBI. My pre-op is March 9 with surgery on March
12. I'm sure the bills will come pouring in soon after.

I'm in it for about 11.6K deposit + the $600 phone call so far. SBI's deal is that they will check your insurance, and if it is
"OK", the worst damage you suffer is about 20K (e.g. your carrier goes bankrupt and SBI gets stiffed).
Of course, that excludes all other doctor/hospital costs.  SBI is not associated with any carriers but "works
with them".

I have setup a "thestaus" page, but really havn't populated it yet.

Good luck Ceecee with your chosen path.

 sjwill


Diagnosed 10/03/2006
2.6cm, Grade 3, highly cystic.
Scheduled surgery at SBI March 12, 2007.
http://www.thestatus.com ID:90222060233
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