Finding the right doctor

[trkdoc714]

My wife and I finally found a competent Orthopaedic surgeon. From my experience, I searched extensively for someone that offered ALL treatments for the spine, Emory Orthopaedics in Atlanta. They're part of Emory Medical School.

My wife.

Previously diagnosed with 2 ruptured discs with a 3rd one fading fast. The original ortho scared her into thinking she needed to rush into a 3 level fusion before her spine collapsed and she would be crippled for life.
Dr. Rhee at Emory diagnosed C6-7 as being ruptured wild mild bulging at the other 2 levels. He offered both fusion and ADR options. When asked what he would recommend, he stated "If it were me or my wife, I'd select fusion. I'm not that much of a risk taker and fusion has a 50 year successful history." We both appreciated his honesty (and integrity).

He never once offered to put her into the Kineflex trial he's involved in. He was more focused on what would be in her best interest.

My back issues.

He suggested laminectomies at L3-4, L4-5 and L5-S1. The discs with bulges and tears should hold up for a few to several years. He didn't think laminectomies would preclude me from ADR in the future and would allow ADR technology to advance further. He declined my request to install a zipper instead of sutures after the surgery (I always try to think ahead).

We were both examined by another doctor prior to his exam. Both doctors were in the office and concurred with the treatment options.

To end this, until we found a surgeon that offered all surgical options, we were only going to be offered treatment(s) that particular surgeon was comfortable with. It's kind of like taking you car to a body shop to get a tune up. They probably know how it's done, they just don't have the tools in their toolbox.

Bob

[Justin]

Bob,

First of all, I'm sorry to hear that both you and your wife suffer from spine trouble. However, with your sense of humor (a la zipper) I'm sure that helps both of you get through the hard times.

Dr. Rhee's comments are very similar to Dr. Guyer's comments at the Texas Back Institute when I was evaluated for surgery.

He said, "If you were my wife and she was 23 years old, had exhausted all conservative treatment and surgery was her only option, I would suggest ADR to give her the best possible outcome by allowing the operated segments to continue to have motion. A multi-level fusion at such a young age will require one, if not many more, operations down the road, especially considering your activity level and to be honest you only have two options at this point: a 2-level fusion or a 2-level ADR."

One has to truly respect surgeon's like Dr. Rhee, especially when he could have suggested the clinical trial that he is involved in like you said.

It is also so very true that surgeons only offer what's in their "toolbox." I had to fly to Texas to be evaluated for ADR surgery, as I was living in New Mexico at the time and they hadn't even heard of ADR for the most part. A surgeon in NM evaluated me and concluded that my only 2 options were: surgery and surgery. Luckily, he knew about the clinical trials in Texas regarding ADR and suggested I avoid fusion and pursue this "new, promising technology that I think has a lot offer, especially due to the fact of how young you are."

Long story short: I didn't meet criteria for the clinical trial in Texas (they weren't doing multi-levels at the time), so I pursued my options with Dr. Bertagnoli. This worked out extremely well for me, as he has the most experience with multi-level ADR and I could avoid being in the "learning curve" for the stateside ADR surgeons.

At the end of the day Bob, you're spot on. Surgeons recommend what they are comfortable with and the procedures with which they have experience. It was funny how many times while pursuing ADR surgery I heard from surgeons that strictly performed fusions--"Oh, I heard the Clinical Trials are having a lot of trouble and the early results look horrible."

Good luck in finding the right surgeon and I wish you and your wife the very best in your pursuit!

[trkdoc714]

Thank you Justin. My wife went to another ortho yesterday afternoon. He concurred with the Emory surgeon. Funny thing is, he works for a different office of her first ortho (Fuse, fuse, fuse & fuse). She's all pumped up about it(I am too but with lumbar issues, I'm afraid if I wet myself it will be misdiagnosed as Cauda Equina).

As far as my possibilities, I have to decide if lamenectomy is the right path. The main concern is once inside, he may find another issue that might make him decide to fuse one or more levels. The zipper would come in handy in that scenerio.

But I have to get something done. Limping around hunched over pain is bad enough without that type of pain too. I may as well complete the role and start wearing wine colored leisure suits and cruise retirement communities for babes.......

How did your appointment with Dr. Bertagnoli go? Does he have a solution for you?

Best wishes,

Bob

Hi Bob
I received a reply from Dr B. Would like more test from a nero, to see were the nerve pain is coming from?
And all my MRI as far back as 1994
Stenum would a one level ADR?

good Luck

Gil

[trkdoc714]

That's great Gil.

Be prepared for the Myleogram. It can be painful afterward. They should give you something for the pain, I just wanted to warn you. But it is fun to ride the tilting table after they inject the dye.

I've never had a discogram, but I understand it's about the same (painwise) as the myleogram.

Did the number for Sue Hart spur on any results?

It's good to hear you finally getting someone to get back with you.

Bob

Hi Bob
Been their done that, the worse headache I ever had woke up at 2 AM in a motel room with my wife and son.I spent the next two hours in the shower drinking a gallon of water and ready to dial 911.Hot water then cold and hot and cold.... They never woke up?
Next test EMG,MCV

Thanks

Gil

[trkdoc714]

I'm not sure what the MCV is but I had an EMG this past January. The neurologist was good at explaining what he was doing and why. The muscular pain lasted for a few days afterward but wasn't as intense as the myleogram. You'll do fine and it helps provide a "map" for your doctor(s).

Good luck Gil.

[Justin]

Hey Mango,

The next test you're scheduled to have is an EMG, electromyography, and a NCV, a nerve conduction velocity test (also referred to as a nerve conduction study).

Electromyography (EMG)

Nerve Conduction Velocity Test (NCV)

I had both tests done and like Bob said, you will be sore for a couple days afterward. These tests aren't that "bad" (painwise) and are able to reveal quite a bit.

Good luck!