Cartiva - Has anyone had it?

I have Obamacare Blue Cross. No problems with getting approval. I am 3 weeks post op and starting to get movement back in the toe. My doctor has done 45 of these already.  It went right thru. 

Thanks for the information Nancy and continued good luck on your recovery!

Jan maybe if you change insurance carriers you could have better luck. I live in Illinois. So far I am happy with my recovery. Once the swelling goes down I hope my old shoes will fit again. I am wearing gym shoes at the moment. 

Jan I do not know if it makes a difference, but I have my insurance through my husband,  United Parcel Service management(different than hourly employees).  I believe that United Parcel Service is still self insured and Aetna simply processes claims on their behalf.  My goal was to be 100% by September, so urgency played a small factor in the physician I chose.  I had three consultations.  The consult with the physician that I chose was on Monday at 1:00PM and we discussed my urgency.  The surgical nurse moved a couple things around and scheduled my surgery for Wednesday at 11:00AM.  In less than 24 hours by Tuesday at 11:00AM I spoke with my carrier, the procedure had been approved and they told me what my portion of the charges would be my responsiblity.  I would definitely appeal the denial.  

Hi Nancy,

i am having Cartiva done on both feet in October by dr vora in lake forest.  Ever hear of him?  when I saw him in June he gave by far the most painful but most effective cortisone shots in both toes.  If only the shots would last more than a few months.....but they don't.  How is your recovery going?

Hi Bon  he gets excellent reviews so you should be fine. I went to Dr Kelikian at Skokie Hospital in Skokie. My guy had only done 40 surgeries before mine.  I am already walking 2 miles a day.  The hardest part of this surgery is the pain on day 2 and day 3 and elevating your foot and icing for as much as you can during the first 2 weeks. I did walk outside for the 2 first weeks for about 20 minutes a day with the heel bearing shoe. As you can tell I am not one to sit still for very long. I am now almost at 4 weeks and wearing my gym shoes and some other sketcher slip ons that I have. It hurts to wear my flip flops so I havent worn those yet. I have been doing cortisone (painful like you describe) for the last 10 years and finally they stopped working. That is when I knew I was ready for the surgery. I walked on the outside edge of my feet to go to the bathroom and around the house when I didn't feel like wearing the heel bearing shoe in the house. I can't move my toe so well just yet but all the pre surgery arthritis pain is gone!! It will take months to gain movement back in my toe. But I can live with my toe not moving all the way as long as the pain is gone.

Thanks for good word on Vora and sharing your story.   My concern is that one foot will take and the other won't, but that is the risk.  I had a failed chilecomy 7 years ago and the recovery was brutal.  I'm still moving forward as everyone on this board knows has just made my life miserable. 

I excercise  4 days a week, two other a trainer doing strength, two cardio.  How long before I can do something?  

All my docs recommended not to do chilectomy saying success rate was not good. So I didn't op for it. You can do strength training right away just no running or jumping for about three months. I am sure it will take if you wear the heel bearing shoe for the first two weeks. That is when the heeling occurs. You cant even see the scar I hAve on my foot.  How many sirgeries has vora done?

As of June he had done 20.  What is a heel bearing shoe (have an idea..)

Go to the darco website and u will see a picture there.  Its called an ortho wedge forefoot. You walk on your heels and your foot is flat in the air on the base. You dont want to walk on ur foot flat for two weeks. I walked on the outside edges of thaf foot to stay off my big toe. Did your doc tell you what ur post op shoe would be? 20 surgeries is a lot you will be fine. 

I would get it done sooner rather than later if you can. You dont want to slip on the ice when it gets colder out. 

Hi Nancy

Glad your recovery is off to a good start Since this is a relatively new procedure, wouldn't 40 surgeries be a lot?  Obviously this question can be raised for any type of surgery.

I'm considering getting this done next year, but should I discount a doctor if he/she has only done a handful of them? Many doctors haven't had as much opportunities to do Cartive, but if they're well trained, is it enough? 

Hi Garet - I visited one surgeon and he had only done one of them.  I decided to go with the one who had done 30 of them at the time. I think going to a surgeon who has done 10 of them would be fine.  The procedure if fairly simple. Did you watch the animated surgery on you tube.  There is also an actual surgery being performed on you tube too. It seems pretty straight forward to me. My scar is pretty much non existant. I think the better surgerions can do a better sewing job for the skin. But it's only feet so it doesnt have to be too pretty to look at afterwards. I just want mine to work alittle bit and not hurt anymore. The worst part of the surgery is day 2 and 3 after the block has worn off. And then laying on the couch for 2 weeks straight. But I am walking 2 miles a day and going shopping all day after that. My foot swells. I go to bed and when I wake up the swelling has gone down again.  On Friday I start work again. I am a teacher so I will be standing, sitting and walking around a lot.

Hi Nancy:

I am scheduled for this procedure in Boston (MGH) on Monday.  My surgeon has done 11 of them.  Of the 11 he has had to remove one. I am wondering about any tips for the 2 and 3rd day pain wise. I am trying to be prepared for how bad it will be. From reading this blog it looks like people have different experiences. My doctor prescribes strict elevation and ice for two weeks and I plan on following this but for bathroom breaks.  Thanks for you reply.

Abbe I took tramidol with tylenol and then tramidol with ibuprophen. I cant take codeine so tylenol with codeine was out for me. The thing that knocked out the pain for me the best though was just 600 mgs of ibuprophen.  I only had pain day 2 and day 3. Day 4 was totally fine.  Day 1 the block was still working until about 1 am when I had to start taking tramidol and tylenol.

do you know why one of the cartiva had to be removed? Do you know how long it had ben in? My doctor says same as yours for first two weeks.

 

Agreed.  I am going to see dr vora in early September to discuss everything.  I know I have to do it.  The recovery sounds rough.  If i take codeine more than 2-3 times in a row my face itches.  I just had dental surgery and did narco with Benedryl.  Well I felt nothing cause I was completely drugged up.  Thankfully I was able to get off of it within a day.  I tried 600 mg of Advil and my stomach did not like it.  I am on Mobic  for the arthritis so I switched back to it and managed the dental pain better than the Advil.  Any thoughts for this surgery?  I have tried tramedol for another dental procedure.  Threw it up.  between my feet and my teeth, it's been a ride

I did have to take prilosec for a few days after I took the ibuphrophen. I just read if you dissolve the motrin in a glass of water first it isnt so hard on the stomach. Another option maybe Darvocet. You really only need meds day 1-3. Day 4 i switched to tylenol. It wasnt bad at all. Dont forget to buy a plastic sleeve to go over your leg for showering from Walgreens to keep it dry. Much easier then taping a plastic bag on there every time. 

Abbe good luck Monday. Dont forget to buy the plastic leg sleeve from walgreens so you can take a shower without getting the bandages wet. The pain isnt that bad.  I walked to the bathroom on the outside edge of my foot. It jusr feels like a stitches pulling sensation. They wrap the bandage so tight after surgery for compression that it doesnt hurt. 

Thanks. I remember darvocet.  Did I mention I am having both feet done? Need two sleeves!  How long are all the bandages on?   

2 weeks u cant get them wet. U will be able to walk dont worry. The pain isnt that bad. I lived in pain before the surgery, i am used to toe pain. 

bon125

I am sort of in same boat as you. Failed chilectomy with arthroplasty in January 2015. I have to do something. Two orthopedic foot and ankle surgeons think I am good candidate for cartiva. I am just further investigating, had MRI to take back and show them. They know I am bone on bone, just want to make sure there is nothing else going on in my foot that might cause cartiva not to work.

are you in PT? When did doctor tell you to start trying to manually move that toe back and forth. I am hearing scar tissue build up is big problem if you don't.

Same boat as you only had chilectomy in one foot. It didn't work, I am bone on bone, not doing anymore cortisone, as I don't want to further damage the joint. Praying the cartiva works!

 

Karen I am now five weeks post op. I have a lot of swelling so just ordered a compression bandage for that foot.  My doctor doesn't believe in PT. He also does not believe in doing any other work on the foot when doing cartiva, he says all bone needs to stay intact for implant to take. He said I won't gain any additional range of motion from what I had pre op. I could barely move my toe pre op so I am not expecting a ton of movement post op. I just want to be pain free. He said it takes five months for all swelling to subside. I started exercising the toe the minute the bandages were off at two weeks. I went in with the understanding that if this doesn't work I can do fusion later. I signed up as a guinea pig and know what I am in for, but I am thinking this is going to do the trick and save me from fusion, 

Always good to cover your bases.  I am confident with who I am using.  Very concerned abt recovery.  That chilectomy recovery was awful.  But I cannot continue to live like this, so I'm doing it October 17.   I dream about putting shoes and it doesn't hit a mean bone !

Good luck!

The recover is not bad. Days 2 and 3 bad pain. Day 1 block still working from surgery. Day 4 just taking tylenol. I didn't think it was bad at all. I iced a lot for the first two weeks. I elevated for two weeks most of the time. 

Hi Nancy, where did you have this done? Can you give me the name of the doctor and the hospital? I've been searching, but since I'll be paying 100% of the cost, I've got to be selective as well.

You are paying because insurance won't cover it or because you don't have insurance? I put together my first level appeal for my insurance company denying the Cartiva implant and will appeal it further if need be.  I am hoping the 1st level internal appeal will be enough.  More insurance companies are now covering the procedure. and in the US its been FDA approved since July 2016.

Hi, I'm glad that you got covered.  At present I don't have insurance because I'm not living in the US. If I was in the US, and had Obamacare, I'd have $6,000 deductible on top of premiums (I wouldn't qualify for any significant subsidies). If I get it done in the US, looks I'll be paying a lot either with or without insurance. The costs are too high for me in the US, but reasonable in Canada, so I'm considering doing it there. I'd gladly pay to be able to be active again without the pain.

Garet you should def look into Canada as I think that's where they started it in the first place. 

garet not sure why you are picking a plan with such a high deductible. We have a plan with only a $500 deductible, $1500 out of pocket max.  Different states offer different plans,  this is what we have found. We are also in an HMO. 

$1500 out of pocket max plans must be highly subsidised which only certain income levels qualify for. Cartiva done privately in the US is ridiculously expensive without insurance (almost double the cost of having it done in Canada).

I would get insurance if I could, but US citizens living abroad aren't eligible for insurance under the ACA (Obamacare). Cartiva surgery isn't offered where I live though I could get a fusion from a general orthopaedic surgeon. That's the last resort.

Exactly. I've been looking into Doctor's in Canada. The only trouble is arranging the dates because I have travel a long distance to get there.

I am sure it's difficult.  Then you need to plan for the recovery too depending on what else you have done. Overall, it will be a relief to know you are with the people on the cutting edge of this.  They are perfecting the tweaks that only work in your favor.  Seems like all the other docs look to them for advancing their approach.  Good luck.  

I am one week out.  Had to get my split adjusted.  One more week total elevation so I can hopefully get in a boot next Tuesday.  

I am sure it's difficult.  Then you need to plan for the recovery too depending on what else you have done. Overall, it will be a relief to know you are with the people on the cutting edge of this.  They are perfecting the tweaks that only work in your favor.  Seems like all the other docs look to them for advancing their approach.  Good luck.  

I am one week out.  Had to get my split adjusted.  One more week total elevation so I can hopefully get in a boot next Tuesday.  

Garet sorry for the delay....I saw this a couple days ago, but lost it in the thread.  I wanted to caution you on getting the procedure done very far from home.  I am not sure what your plans are for your follow-up appointments, but if you have any distance to travel it can be difficult.  My physician was in the Detroit area which is 2 1/2 hours one way on a perfect traffic day.  I would definitely plan a to stay in Canada for 10-14 days until the top stitches are removed.  I believe it was the sixth week appointment that my feet were x-rayed to determine if the implants had seated successfully and whether the bones were healing correctly.  I am not sure that you could get a US doctor to take on the liability of treating you for another surgeons work.  

 

Thank you, that is definitely good advice. If I wait until June, then I can stay around there for three weeks after the surgery. If I do it in October, I'll only be able to stay for 10 days after the surgery. 

It might make more sense to wait if I can deal with the pain, and more importantly, if I can make sure it doesn't progress significantly over the next 9 months. I've given up running and hiking until after I get the surgery, so if I take it easy, I can probably wait. Sometimes even walking bothers me though.