Cryoablation in the US, for the pudendal nerve

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Cryoablation in the US, for the pudendal nerve

Postby hank3.14 » Wed Mar 01, 2017 7:14 am

Does anyone know if there's more than 1 US MD who's doing cryoablation for the pudendal nerve? I know about JD Prologo, MD of Emory U. in Atlanta, GA but wonder if any other MD is doing cryoablation for the pudendal nerve. If you know of anyone else, please submit a posting with that MD's name and location.

If only 1 pudendal nerve (1 side) is damaged or ailing in some way, how does cryoablation not freeze the healthy, functional pudendal nerve on the other side? Does the MD only find an area where the 2 pudendal nerves are far enough apart so that freezing of the injured/damaged one doesn't affect the healthy one?
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Re: Cryoablation in the US, for the pudendal nerve

Postby Violet M » Thu Mar 02, 2017 5:56 am

I've heard Dr. Barreveld in Boston does cryoablation but I can't say for sure if that's true.

You can go to the anatomy pictures at the following link and see that the right and left pudendal nerves are very wide apart so it would be very easy to perform cryoablation on one and not the other. There is a main trunk on each side of the pelvis.

http://www.pudendalhope.info/node/13

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Re: Cryoablation in the US, for the pudendal nerve

Postby April » Fri Mar 03, 2017 5:49 am

Hank,

Dr. Hibner told me that Dr. Kay (St. Joseph's Hospital in Phoenix, AZ) does it but that right now he's only doing it on local patients so he can more easily monitor their progress. He said that Dr. Kay learned how to do it from Dr. Prologo.

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Re: Cryoablation in the US, for the pudendal nerve

Postby hank3.14 » Sat Mar 04, 2017 1:10 am

Violet M wrote:I've heard Dr. Barreveld in Boston does cryoablation but I can't say for sure if that's true. .......

Violet


Thanks Violet for the info and help!
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Re: Cryoablation in the US, for the pudendal nerve

Postby hank3.14 » Sat Mar 04, 2017 1:11 am

April wrote:Hank,

Dr. Hibner told me that Dr. Kay (St. Joseph's Hospital in Phoenix, AZ) does it .....

April


Thank you April for both the information and the help.
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Re: Cryoablation in the US, for the pudendal nerve

Postby rick » Sat Mar 11, 2017 10:58 am

Dr. John David Prologo does cryo,

On March 1 , 2017 I had the pudendal nerve and the nerves to both of my testicles treated using cryoablation at Emory Johns Creek Hospital about 45 minutes outside of Atlanta, Georgia. Part of the Emory School of Medicine system. Dr. Prologo, an interventional radiologist on the Emory School of Medicine faculty has done perhaps 250 of these.

Now, just 9 days after the procedure my pain levels are from at least 10 out of 10 to minimal levels with only using 1 600 mg tablet of neurontion, 2 600 mg tablets of cymbalta and 1 .4 mg tablets of Flomax each evening. That is the totality of my meds other than 2 regular tylenol in the morning.

I find that if I am too active during the day my pain levels will start to rise and I need to rest a while. It may be 90 days or so before I reach a final pain level. More later. As far as cost. It took me three phone calls to United Health Care the medicare advantage plan the state of Illinois switched me to as of 1-1-2017 to convince their staff that they would not pay for this surgery. In the end I had to provide United Health Care with copies of their own documents before they agreed they indeed they would not pay.

Since I was private pay Emory Hospital agreed to charge me what they estimated payment would have been from medicare. So, for the hospital part of the process they reduced their charges from over $25,000 to about $7,3000 which I paid before I had the procedure. The clinic charges for CT scans etc, about $2500 were submitted to United Health Care to see what my medicare advantage will pay. I think the clinic fee includes Dr. Prologo's fee because he is an employee of the Emory School of Medicine, being a member of their faculty.

So, maybe a maximum of $10,000 in medical costs. A three night stay in a Johns Creek hotel. I would have stayed only two nights but my wife became ill at the last minute. Airfare from central Illinois, hotel, shuttle, taxi fee's etc. probably another $1000.00. No overnight stay at the hospital, just a request to spend the night after the procedure locally in case of a complication.

Total cost to me $11,000 plus a 10% set-aside, by me, for contingencies. Not cheap but it meant my requirements: not invasive other than nerve blocks and the cryo procedure itself.

Result: within 7 days pain levels reduced to perhaps 5% of those before the procedure. I am 70 years old and get very little restorative sleep due to multiple sleep disorders, very little stage 3 and/or 4. Plus I sleep a maximum of 4 to 5 hours a night, I have severe sleep apnea but do not go into deep enough sleep. Unless totally exhausted I never wake up with the machine still connected. Even then it would be a maximum of 2 to 3 hours.

Emory prefers to do the procedure using two visits. The first for consultation and nerve blocks. The second visit for the procedure after submitting claims to insurance for estimates, etc, Since I had already determined that I would have to self pay the majority and provided them with a paper copy of Hollis Potter's evaluation done in January 2012 they did it in 3 days and two nights with no in hospital stay. I did spend a third night in Johns Creek because I had to travel alone. Dr. Prologo told me that he had to put huge amounts of cryo through me since I had developed PN probably in the early 2000's and had significant damage from my fall in June 2005. Large amounts of cryo can cause confusion.

So: J. David Prologo, M.D.
Emory at Johns Creek Hospital
6325 Hospital Parkway
Johns Creek, Georgia 30097
Patient Care Coordinator: Claudia Frederique
(678)843-7197
(678)843-5357 (fax)

Don't be afraid to considering become a customer. I had 5 nerves frozen. Updates to follow. Take care.

Rick


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Re: Cryoablation in the US, for the pudendal nerve

Postby Violet M » Sat Mar 11, 2017 9:06 pm

Thanks for posting this info, Rick. It's been a long haul for you, that's for sure, and I hope things continue to go well for you after this procedure.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Cryoablation in the US, for the pudendal nerve

Postby rick » Thu Mar 16, 2017 11:28 am

Hello,

I am now 2 weeks past treatment with cryo by Dr. Prologo at Emory Johns Creek hospital outside of Atlanta, Georgia. When, in the past I had been on huge amounts of medication, I am now practically med free. I continue to take 1200 mg of Cymbalta each morning and .8 mg of Flomax each evening. Other than that I take straight tylenol; 1000 mg 2 times a day, or sometimes I will add ibuprofen at lunch. No other medication. I am perhaps 90% pain free. I was told by Dr Prologo and his staff that I could expect that it could take up to 90 days for all the pain to go away. I think that is realistic.

Since I am 70 years old, sleep now, after the procedure about 6 hours per night and have multiple sleep disorders; severe sleep apnea that I am unable to treat with my cpap machine because I spend very little time going into stage 3 or 4 sleep. My lack of deep sleep is caused by alpha delta wave intrusion which impedes my sleep process greatly. As for using my cpap machine, I simply removed it, when I used it that is, after I fell asleep. No matter which sleep medication I tried or how exhausted I was, I would wake up with the machine shut off, I set it so it would shut off automatically when it was removed. I was never able to use the face mask but used the nasal pillows always updating to the latest version.

Before the cryo treatment I just had in Atlanta I almost never took a nap, sometimes falling asleep in my recliner in the evening watching a little tv or reading a book. I now sleep about 3 hours at night probably from midnight to 3 a.m. and take a 1 to 1 1/2 hour nap 830 to 1000 am after my wife Angela; we will be married 43 years on April 6, goes to work. A business consultant in the past with over 500 businesses done I am now working with my youngest son. He is putting together an innovative business model that I can help with the needed structure and components.

Next week I watch my 10 year old grandson Bob. Interested in becoming a scientist when he grows I have a lot of house hold jobs such as repairing a broken ceramic towel rod that he can help determine how the two of us can get it done together. I will also have him for the summer. I need a new computer, I still like a desktop even though I have a laptop, a notebook. I don't care for anything smaller. So Bob and I will build my new one together.

So I wait for the rest of my pain to go away. I have to limit my physical activity; a little less each day or else some more of the pain returns. Dr. Prologo says that patients are usually pain free after 90 days. I expect that in my case it will be a little longer.

The cost? After being assured by my medicare advantage plan - 3 different representatives, 3 different telephone calls. I finally convinced them that they would pay very little. I had to point them to their company document last printed in December 2016 that listed procedure codes that would be denied including the one for cryo of the pudendal nerve listed there in blue and white on my computer screen.

Emory, to its credit, charged me about what the would have been reimbursed by Medicare, maybe less. The hospital, a little over $7000, payable the day before the procedure. Dr Prologo's charge and the clinic will be about $2500 to $3500, some of which will be paid by insurance. So maybe at most $11000 medical. No overnight stay in the hospital, just my word that I would stay in my local hotel.

I traveled alone. They wanted a driver but my wife became ill about 3 days before we were to leave. I stayed a extra day at the hotel. Dr Prologo told me he had to put "huge amounts of cryo through me." The main side effect, some confusion. Hence, the extra day. Travel costs; plane, hotel, shuttle, taxi, etc about $1000.00.

So, maybe $12,500 out-of-pocket. Dr Prologo has now done about 250 of these procedures. You might want to give him a try. Remember, nothing invasive. No slicing or dicing. Take care.

Rick
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Re: Cryoablation in the US, for the pudendal nerve

Postby April » Sun Mar 19, 2017 6:07 am

Thanks so much for the detailed post, Rick. I'm so sorry to hear that the medicare didn't cover it. But, it's great to hear that you are doing so well and sleeping a bit more and able to do more things with your family.

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Re: Cryoablation in the US, for the pudendal nerve

Postby jaxi123 » Thu Jun 01, 2017 3:24 am

All of you who had cryoablation, how are you now doing?
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