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twowheelyankee
07-01-2016, 11:39 AM
Hey all,

While I have decided to postpone surgery, I initially requested Dr. Zeeger's paid service of a full analysis of my lumbar condition. It has been over two months and he still has not provided any report or analysis. I have sent him an email every two weeks asking for progress and an estimate and his response is that quality cannot be rushed.

Has anybody else had an issue receiving a timely report? I know the European Union is in chaos right now, but that is no excuse for a doctor to default on his paid services.

Thanks,
Jim

pbrav
07-03-2016, 02:00 PM
Hello. I am in much of the same situation as you. I have been waiting for Zeegers advice for three months now. I know he is working on it though. He called me recently to advice me against a certain course of action I had asked specifically about, but said he needed more time to work out a full report and advice. As I understand it he often asks for opinions from his contacts among other surgeons as well, and this will take time. I trust that he actually will deliver, and from the phone call I got the impression that he actually is as thorough and well qualified as his patients say. So, I think it will be worth the wait - but I must admit I get a little frustrated just like you.

spineally challenged
07-07-2016, 07:44 AM
HI
I’m in the same situation too. I’ve been waiting just over three months and I’m a prior patient of his - so no favouritism there! Hopefully the wait for all of us will be worthwhile..
wishing you all well, Tim

twowheelyankee
07-07-2016, 09:55 AM
Honestly, I am disappointed that his reputation precedes him. If I had known it would have taken over 3 months for a medical report, I would not have done it. Based on our conversation on the phone, Dr. Z indicated it would take 2-3 weeks. Then on May 25, a month later, he said 10-14 days. 6 weeks later and he does not even respond to emails.

So yes.....I hold a man to his word, especially since he has been performing surgery for over 2 decades. He is a professional and a service was paid for and not provided. We have words for that in the US..... :censor:

So.. I am no longer holding my breathe. Integrity.... whatever happened to it?

Cynlite
07-07-2016, 11:44 AM
Dr. Zeegers kept telling me to get more tests done which my insurance wouldn't cover and so, I never did get his final report. I paid out of pocket for the nuclear test he wanted that showed no infection and he still wouldn't give me his final diagnosis. It took me about a month and a ton of phone calls with doctors here and emails with him to try and figure out what the heck he wanted! Tests in Germany and tests in the U.S. apparently don't translate well. He wanted me to go get a CAT scan too but, at that point I decided to go with Dr. Clavel and trust his advice.

It took Dr. Zeegers about 9 weeks to give me my draft which was basically all the information I gave him typed up so, he didn't give me a lot of guidance that was useful to me. He's a very nice man and his reputation as a surgeon on this board has always been good. I've never read a bad thing about him. In my case, he was focused on my neck x-ray and thought the bone fusion didn't look right. He told me that before I paid him and he never moved off that topic. It really bugged him. I trust his experience and skills as a surgeon but, at some point we have to make a decision when the surgeons are not agreeing with each other. So, I gave up on him.

In his defense, it took Dr. Clavel about 8 weeks to give me his opinion. Dr. Bierstedt was the quickest but, I felt that Dr. Zeegers and Dr. Clavel were better for me. So, they both take a long time to respond but, it will be worth it once you get past this waiting period. I think Dr. Zeeger's is a pretty conservative surgeon so, having his input will be valuable to you once you get it. I do appreciate the time I spent with him on the phone. Also, once summer hits in Europe, the response time gets even slower because everyone goes on vacation there and they take long vacations. I know how hard it is to have patience when the body is in so much pain. Us Americans don't like waiting but, it is what it is. They have a different culture over there.

twowheelyankee
07-11-2016, 11:00 AM
Thank you Cynlite and others for your input.

I am glad that I am not the only one that was waiting for a "long" period of time. Dr. Clavel and Dr. B responded to me in weeks. Dr. Bertagnoli had a response with in a week and says I was a candidate for a "Mobi-C" device even though I have L4/L5 issues. hahahaha It was his assistant Jay that I communicated with so I doubt the doctor ever saw my paperwork.

If Dr. Zeegers had said it was a 2-3 month process, I would have been content. But on several (more than 3) occasions he indicated I would have my report with a week, or 10 days, or 10-10 business days.

Now that I have pressured him for the report, I feel it will be rushed and it will basically regurgitate what I sent him. It will just be a neatly organized summary of the data. That was not what I was looking for.

I received an email this morning promising me to have the report by week's end. :nono: Not holding my breath.

Thanks again for the time and input provided. I will follow-up when I get my report and the content.

Thanks,
Jim

Cynlite
07-11-2016, 12:38 PM
If he didn't ask you for any more tests, I would assume he will give you his recommendation at the end of his lengthy report. Another patient hired Dr. Zeegers last year right after me and had the same long wait. Sounds like he is almost done and you'll get your answers. :) He's just a very analytical guy and the report will confirm to you that he paid attention to everything you told him.

Dr. Zeegers did tell me he only recommended two ADR's in my neck IF I was a ADR candidate (see notes above.) Dr. Bierstedt recommended ADR for the same two levels. They were both more conservative. Dr. Clavel however said that I had significant cord compression at the one in the middle so, he recommended three. No other surgeon made that comment. It was a tricky decision but, I went with Dr. Clavel and the rest is in my post surgery story.

Dr. Zeegers is known for being a great lumbar surgeon so, he is worth the wait. (Not a lot of people from this Board went to him for cervical disc replacement so, for him I just lacked the data I wanted plus, the other things I mentioned.) I know it's frustrating but, at least you are almost there! The other thing about Dr. Zeegers is that he will talk to you on the phone a lot about his diagnosis. He's a good ear to bounce your thoughts off of when trying to noodle out this puzzle.

RiverMiles
07-14-2016, 09:28 PM
Hi all.
I just submitted my docs and records to Dr. Z a couple of weeks ago and I appreciate this thread because it tells me what i am apparently in for!
I have to say it really surprises me though. I've read where some members have had trouble getting responses from surgeons overseas. Dr. Z himself called me within half an hour of my initial email to him. I almost dropped my phone!

Cynlite
07-14-2016, 09:53 PM
LOL, he is that way. He's really good out of the shoot. I had the same experience but, he will take time to get you his final response.

It's such a puzzle to put this together. He really didn't play a lot into my final decision but, I don't regret working with him. He's a good man, honest IMO and a high analytic so, you have to be able to engage on that level with him. As far as spine surgeons go, he's one of the more "real" ones.

It was pretty darn expensive but, how do you put a price on your future? I put my health first because everything else is meaningless if you don't have the ability to live life. Having input from the best surgeons in the world, helped me decide what was best for me. It starts out as an analytical decision and then becomes a gut feeling...if that makes sense. I hope it does.

I wish you the very best outcome and hope you find a pain free life soon. Patience is the key for all of us and holding on to hope for release from pain. Don't ever give up.

P.S. Several people I know of just had surgery from Dr. Riew in New York City. He has an impressive resume and specializes in cervical patients but, I only know of these two and they just had their surgeries two months ago. If he's in your network, he might be worth checking out too.

P.P.S. I'm so sorry your insurance company screwed up your surgery. When things like that happen, I try to think that something better is in store for me.

RiverMiles
07-15-2016, 08:29 PM
Hey Cynlite - I really appreciate the hopeful words and the lead! My impressions of Dr Z and his character are the same as yours. And it was his thorough, methodical reputation that drew me to him in the first place. Guess that's probably true of all of us.

The first neurosurgeon I met with looked at my films for two and a half minutes then told me I needed a two-level acdf. This approach, obviously, represents the other extreme, the anti-Zeegers, if you will. While I'm not qualified to dispute that assessment, I can say it didn't help me understand my circumstances or prepare me to make one of the most important decisions I will ever make.

We learn pretty quickly that there are no certainties in surgical outcomes. But I think the kind of comprehensive, highly individualized analysis you receive from someone like Dr Z can at least help instill a sense of certainty that you are having the correct surgery or are correct to have or to not have surgery, can help to empower you to make those decisions confidently. That's my hope anyway. So I was prepared to wait and it would be misaligned with my ultimate goal of making an informed decision to rush Dr Z's mojo. Kind of like asking him to, "try and make this operation thing snappy," in pre-op.

Joking aside, I know it's not about rushing him; it's about something you need being delivered as promised. And yankee, pbray, and challenged, I hope you receive your reports soon and they help you achieve outstanding outcomes.

Cynlite
07-15-2016, 09:10 PM
@Rivermiles, I don't know if you read the final end to my story. (FYI, had the same experience with a short interview in the U.S. and fusion suggested.) I had a three level ADR with Dr. Clavel in Barcelona in May 2016. Dr. Zeegers held me up in my decision. He was way too conservative on his diagnosis of my neck but, spot on on my lumbar in my opinion which is not a surgeon's opinion because I'm not one...I just live in this body and had to make a call. That is where trusting my own instincts about what my body was telling me came into play. Surgeons are not Gods. I knew I was gambling so, it came down to probabilities in my mind. There are risks and we can't ever forget it no matter how good the surgeon. I think Dr. Zeegers is one of the best conservative surgeons and Dr. Clavel is one of the more successful surgeons when it comes to cervical surgeries based on my research. This is important...you'll have to come to your own decision based on all the information you gather. Dr. Clavel recommended an L3/L4 fusion at first review of my images but, after talking to me in person did not push me for it. He understood my arguments. I made a call to hold off on that surgery and it may cost me more later financially if I choose to do it but, after so many surgeries I've learned that they should not be taken lightly. So far, I think I made the right decision. That is as far as I got. I had a 3 level cervical surgery with Dr. Clavel; one I don't think I'll ever regret. I'm 8 weeks post op so, can't say what the long term prognosis will be but so far, it's been a good recovery so far and I'm happy with my decision. I hope your decision is easier than mine and wish you the very best outcome!

RiverMiles
07-15-2016, 10:27 PM
You and me both! I'm aiming for at least original factory condition!

I saw that you ultimately had to leave Dr. Z to his deliberations and move forward. Based on what I learned in this thread, I will probably be reading my final report from Dr Z while I'm recovering from surgery.

I was just commiserating about the wide range of attentiveness between different surgeons and what they represent to me. I hope it didn't come across as absent or off point.

The good thing about the appeals I'm working through is they afford a little time for more second opinions, research, and distilling it all into the right call for me. I'm 100% on the same page in terms of weighing the assessments, indications and recommendations against my own intuitive compass and judgement.
I could be better at it though. :-)

twowheelyankee
07-18-2016, 11:29 AM
Here is the last response I received from Zeegers:
Willem Zeegers <wzeegers@zeta.demon.nl>
Jul 11 (7 days ago)

to me
Report will be finished this week

As you can see, again this deadline came and went. This is the fifth time he failed on his promises. I could understand 1 time, but this has become habitual and unprofessional. Yes, he personally calls you quickly on the initial consult. That is why people feel comfortable and wire him money for his opinion. But you will soon learn that he delays and when he finally provides you will a report, it is basically reorganized information that you provided to him. So I hear, since I do not have my report. I am not sure how doctors are made in Europe and the Netherlands and the social healthcare aspect of it, but I feel he is making some good money with these international consults.

My initial intent was to have surgery in September based on his analysis. Luckily, I did not make any travel plans. I need my surgeon to be a person of their word. To me, Dr. Zeegers is not providing his international patients any respect. I would not feel comfortable suggesting anybody use him for an international consult. I CANNOT speak for his ability as a surgeon. This is key. I have no knowledge of his surgical abilities.

Good Luck....
Jim

twowheelyankee
08-08-2016, 05:42 PM
So after 3 and a half months, and numerous emails requesting status, He finally sent me an 8 page report. Yes an 8 page report, where 90% of the report is information I provided him. He did add a lot of terminology to obscure any recommendation and really never provided one.

So while I am not quite as diligent as some on here with exhaustively researching everything related to ADR and back diseases, I did research my condition which is a single level ADR due to a herniated L4/L5 disc.

Unfortunately, Dr. Zeegers report did not provide any additional insight into my condition or potential solutions.

For me, Zeegers analysis was not worth the 1K(>) USD.

TBI only spent 45-60 minutes considering me as an ADR patient and provided the same feedback.

I didn't expect the report to be magical, I just expected it to be comprehensive and complete. A place, one concise place, that would document my condition.

I am guessing I will spend the next month trying to pull information from him.

Jim

Cynlite
08-08-2016, 07:08 PM
The end of the report (really the only important page) should say something like:

1) Do nothing ...wait and watch, not really a good solution ...
2) Some sort of recommendation by Dr. Zeegers

Did he send you just a draft like he did for me? My recommendation section was not an opinion but, rather open ended questions.

My apologies to all of Dr. Zeegers patients that posted before 2015 and are happy patients. Unfortunately, I have to agree with Twowheelyankee in that the $1000 I spent last year on him was not a great investment for me either. Oh well, bygones.

Twowheelyankee, I was sure hoping that Dr. Zeegers would come through for you. Perhaps there is more to come?

drewrad
08-10-2016, 03:10 PM
Yep. Me too, I'm afraid. Money wasted....

twowheelyankee
08-15-2016, 11:10 AM
Yes Cynlite.....

There were more questions in his draft than there were answers.
In the Treatment alternatives discussion, he suggests 4 things, one of them is ADR at L45 with Active-L. The others include do nothing, get a discography, and the other addressed a concern of mine related to the height of the herniated disc.

Dr. Zeegers is a brilliant man, I have no doubt. I completely give him several passes because English is not his first language and it may take several back and forth emails to clarify questions.

I have a feeling Dr. Zeegers does not have a staff to help him with these international consults. He indicated he had some personal issues in his life that caused the delays. If a doctor is not available, you would expect his staff to update his patients. Unfortunately, he made too many promises and failed to execute on any of them.

My biggest concern was a low Z score and I asked him to comment on this and how if affects ADR. His only comment was, "mayebe somewhat poor".

I am the simplest form of a potential ADR candidate. Single level, no apparent facet issues, lordis good, no other remarkable indicators in my images or reports, save for the bone density.

In conclusion, it is buyer beware. It seems ADR/spinal surgery has become a marketeer's dream. Lots of advertising and promises of easy recovering (compared to fusion), pain-free lifestyle, etc. The other European doctors, who provided free consults (Clavel, Bertagnoli, etc), also indicated I was a candidate solely based on one set of MRI images and had a turn-around time in under a week.

I know it sounds like I am talking out of both sides of my mouth.. one doctor took too long, the other doctors responded too quickly. I also question myself. But you get that feeling, that hunch, where you know something is "hinky". I have never put this much research into any other surgery or doctor. I guess because back surgery has been a crap shoot for so long... 50% patients no better, 50% in more pain. I am hoping/counting on ADR changing these numbers. It has been around long enough in Europe to see some long term numbers. Plus, the risk of surgery outweighs the constant day to day pain and the reduced quality of life.

jim....

Cynlite
08-15-2016, 01:44 PM
Twowheelyankee, I too have spent more time researching ADR surgery, fusion surgery and stem cell treatments more than anything else in my life. There is a good reason for this. My spine problems took everything I enjoyed away from me and destroyed my quality of life for many, many years. I pray you never get this bad! It was not because of procrastination on my part but, rather because of a lack of good options to heal me. I am so grateful that the ADR technology and surgery advanced so much in the last 10 years in Europe! So far, the three M6's in my neck have made a huge difference and I am hopeful that my health will keep getting better.

I have problems with my lumbar spine now but, am not an ADR candidate. I think my lumbar problems came early to me in life because my cervical spine was screwed up for so long that it really changed my body strength and posture. This is one of the drawbacks of not fixing the problem(s). My greatest concern of having a one level fusion is the degeneration of the adjacent discs so, I have done nothing surgically. I think that even with the 50/50 ratio you gave, in the end fusion is a losing battle because the mechanics of the spine are changed afterwards. Of the two surgical options, I think ADR by a very experienced surgeon is the best hope anyone has of reducing their pain significantly while reducing the risk of further degeneration to the spine.

Here's my opinion for free :laugh:

1) Do nothing surgically. Build core strength and work on body posture. Live with the pain until you can't tolerate it anymore.
2) Consider stem cell injections as an alternative to ADR surgery. I'm still trying to figure out if they are worth the investment because this type of treatment does not come cheap and has a supposed "70% chance of reducing 70% of the pain." Can stem cells heal your problem? If not, ADR is probably a better option because it will restore your body mechanics.
3) Skype with Dr. Clavel if you are still on the fence and think the M6-L or Activ L are discs that will work for you. It is worth the approx. $200 euro it will cost you. He impressed me on the call more than any spine surgeon in Europe or the United States that I have met and that is when I made my decision to have surgery with him. You are one of the fortunate ones to get an answer so quickly from him. I think I waited close to three months for my opinion. Ask him about your bone density concerns. Alternatively, you could email him your question but, you may have to be patient and wait for the answer.
4) If your insurance will cover an ADR this time, can you go to the Texas Back Institute and have surgery there? Are they still using the Prodisc L there or is the Activ L an option?

I agree that there is much money to be made in this industry which makes our choice of treatment difficult to figure out. It becomes increasingly difficult to trust any doctor because they all think they have the answer. My pain doctor for the last five years was very much against me getting surgery. Was his opinion in my best interests or his....I wonder? Many doctors in the U.S. are very procedure driven and that is always in the back of my mind. The promises of going back to work in 6 to 8 weeks is stated across the board for many types of spine surgeries and I agree with you that this is inaccurate marketing. Everyone is so uniquely different and our recoveries take as long as they take. It seems more often than not, the recoveries take many months not weeks. All you have to do is read lots and lots of post surgery stories to figure this out. After a couple of months of healing and with the help of drugs, a person could go back to work if they had no other choice, felt strong enough and if the surgery fixed their problem...there are lots of if's. From what I have read, the young, single level ADR candidates have the best chance of a 6 to 8 week recovery compared to us multiple level ADR patients. After 40, the older we are, the harder it seems it is for us to bounce back. Plus, it didn't matter that I was in great shape 10 years ago, I lost it and had that going against me for my recovery so, an 8 week recovery just wasn't going to happen and I knew it. However, for most of Dr. Clavel's patients (can't speak for the other surgeons) we feel much better right after surgery than the day before surgery. It's pretty remarkable. But then later, when there is more inflammation from the body healing from the surgery and we are off the drugs, we have a bit of a setback or plateau until about week 8. After week 8, I started making gradual improvements again. The same was true for my other spine surgeries. After 8 weeks, I felt I had done a lot of the healing from the surgery but, in those cases, the surgeries didn't help my pain levels much and then of course, I got worse and my pain story continued.

twowheelyankee
08-18-2016, 11:59 AM
Hey Big C......

Back in March 2016, I consulted a second doctor at TBI, Dr. Blumenthal. My first consult was with Dr. Guyer. I did not feel too confident with Dr. Guyer so I requested a second consult. While non of the doctors at TBI seem to want to send a couple hours answering my questions, I force them too. I harass their staff and their nurses for answers. My insurance does cover single level ADR and I was scheduled for surgery in September.

TBI has some of the best American-based ADR surgeons. Of course, this is always arguable. I feel confident with Dr. Blumenthal or Dr. Zigler. Eventually, I will take the plunge when non-narcotic medication stops working. Dr. Blumenthal has now gone with the Active-L for lumbar, which is what Dr. Zeegers mainly works with for lumbar. I have not research anything with respect to cervical.

Without medication, the pain is unacceptable. I refuse to live my life with a low quality. Therefore, if the quality of life dips again, I'll be in the assembly line for my ADR.

I was hoping Dr. Zeegers could help me with my unanswered questions from TBI analysis. However, i exerted so much effort trying to get a report from him, I have chosen not to follow up trying to ascertain any more information. I have made the conscious decision to cut my losses and focus my research locally.

I have severe doubts about after-care with ADR surgery abroad, especially when I can have it done here for "free" (insurance covered) and follow-ups will not be questioned.

As for stem cells, I was told my disc was too far damaged for stem cells to work their magic. I have not researched this, but being an engineer, my opinion is that once the disc is broken, the human body cannot repair it back to original condition.

I want to hit the slopes again, do some whoop de do's on a dirt bike. Luckily, I am able to play golf, bowl, and weight train with my current pain level without doing further damage.

Thank you for ALL your feedback and timely responses. It does not go unnoticed. Your knowledge and insight has helped me the most. I do truly appreciate it.

Thanks,
Jim

Cynlite
08-18-2016, 01:33 PM
You are most welcome Jim :D Thanks so much!

I think Dr. Blumenthal at TBI is a good choice in the U.S. especially, since your insurance will cover the surgery. He was my second choice but, I didn't have to think about him much because my insurance would not cover a dime of it. He and Dr. Zigler may have more experience at ADR surgery than any other U.S. based surgeons. That is my guess, but I don't know this as a fact. I know Dr. B. is a busy guy. I did speak to him on the phone once but, after he saw my first allergy blood test in the package I sent, he dropped me like a hot potato with no further explanation except he wouldn't operate on me because of the allergy. That was the response from all the surgeons though. In the end, it's not their job to figure out that problem. They are surgeons and they do surgery. I'm sure glad I was able to figure it out and have surgery or I'd still be laying in bed wishing I was dead.

Once my condition became acute, there was really nothing that made me feel better besides staying very still in bed and using heat and ice. However, before that, I found that juiced ginger helped a lot with pain. Try it out or throw a piece in a blended drink and see if it helps you to feel better. I'm pretty much in love with fresh ginger! Think I'll go make a shake right now :)

Everyone swears that Turmeric helps but, needs to be taken with black pepper or pepperine for best assimilation. I've taken it but, can't say one way or the other if it helped me. I think staying really hydrated is very important for the longevity of the spine. There is information out there on it. There are many things that we can do naturally to reduce pain and inflammation in the body. We just have to figure out what works for our particular body. Everyone responds differently. I personally prefer to stay away from drugs as much as possible.

I do hope you can continue to hit the slopes and play hard for many more years to come. It broke my heart when I learned I would never ski again. But you know, back in the very back of my mind is that hope that I'll do it again. I'm a fighter and never say never. The body has miraculous healing ability and medicine is always making advances. Wishing you the very best!

twowheelyankee
08-22-2016, 11:41 AM
I want to add a note to this thread. Dr. Zeegers cam back with a second final report that addressed my concerns and questions about his first report. He made several attempts to make sure I was aware of his new report and I want to make sure I give credit where it is due. I wanted to make sure I was comprehensive in my analysis of the International Analysis provided by Dr. Zeegers.

My opinion has not changed as to the usefulness of the report. It was accurate but did not provide any additional insight/information that I did not already know. I was a single level lumbar candidate so I was not a complex subject.

I will say Dr. Zeegers is one cool headed individual. He never once lost his temper or had ill-chosen words to say to me when I was at the breaking point of frustration.

I have lost respect for the medical profession over the past few years. They no longer value your time, talk down to educated patients, disregard your opinions, etc. Maybe the US insurance industry has partial blame. But I think with easier access to medical information and studies, doctors/medical staff resent patients educating themselves, and spew the line, "You can't believe everything you read on the internet." Well that is common sense, as well as you can't believe, "Everything your doctors says." Because contrary to what they think, they do not know everything and they are not God.

The best doctor is a humble doctor.

take care all......
Jim

Cynlite
08-22-2016, 02:25 PM
FYI, Dr. Zeegers posted that he was looking for a new assistant last week on his Facebook page. That might explain the delays he has been having recently. Glad to hear he got back with you and answered your questions!

zenmunk
11-17-2016, 06:06 PM
I basically had the same issue with Dr. Zeegers. Lightening fast calling you after he gets the first email from you. But then it took something like 5 months before he gave me his official written report. And, the report basically regurgitated the information I gave him. It was a very expensive consultation with info that I couldn't really use to get myself better. He may be a brilliant surgeon, but his consultations leave something to be desired. He also quoted me one price (which I wired to him), but then asked for more money half way through in order to finish his analysis, because it proved to be more work than he expected. If you agree to something, then stick to it. Don't ask for more money to finish what you started. It's not the most professional thing to do.