New poster! DDD L4-L5-S1. Considering ADR/Fusion...
 

Hi there....

37 yr old male based in Los Angeles, CA, USA.

Been dealing with both acute and chronic back pain over last 12 years since I was in my early 20’s. In the last few years it has been persistently chronic back pain and I have finally (with my ortho doc) decided it is time to explore surgery after exhausting every single conservative and alternative treatment available.

I have seen several surgeons in LA but haven’t been super happy with anyone yet and am seriously considering going to Germany for the more experienced surgeons and newer discs. I’m really changing my mind every day whether to stay in the comfort of my own city or go to Germany. Any thoughts?

Also been dealing with depression lately that I’m pretty sure is due to isolating and not being able to work or excercise or socialize like I used to.

Thanks for any input!
J

I am so not a world traveler. Or even a traveler :)


But in my own personal opinion it's crazy to NOT consider going to Germany, Switzerland, Spain, etc...


Yes there are accomplished physicians at TBI and other places. But how many of them have literally implanted like over a thousand ADR's? My guess is exceedingly few.


I'm slowly getting more and more comfortable with flying to Cologne or Barcelona, and spending 2 weeks there.


Oh and disc I'm most interested in isn't even available here anyway.

I'm biased. Laura got her three ADRs at a time when you traveled to the surgeon or you didn't get ADRs; because of that, it's easy for me to say that you should go to a surgeon that you trust and travel to him/her if that's needed.


I've ended up becoming quite the European traveler. Laura and I went to Munich and Bogen a double handful of times for spinal and knee work for both of us. Since that time, I've been to Europe around once a year for business for the past four years.


Practically speaking, getting to your surgeon isn't much of a problem anymore, regardless of whether it's a US surgeon at a distance from your home or overseas. You will need to think about your sitting tolerance for flights. Maybe you need a 1st class seat that folds flat or nearly so to allow you to take strain off your spine. Maybe you need to investigate a sequence of shorter hops instead of really long, long haul flights. Either option exists.


The biggest problem with not getting surgery near your home, at least in my opinion, is that you don't have the support structure available. Not so much during the time in the hospital but the time between when you're discharged and when you can travel to get home. Laura and I have always accompanied each other for the surgery trips so there was always someone to run errands when the patient needed something.


Sometimes finding the right thing was difficult in the unfamiliar city, though. That's largely alleviated now by the prevalence of good mapping websites and smart phones but there's still some difficulty in finding the one odd thing. Gloves to make it easier to use crutches following a knee surgery was one example of a surprisingly hard to find thing that came up as a last second need while Laura was recovering. To be clear, this is a problem with traveling in general, not just overseas travel. Finding the right store in a series of strip malls at night in Denver was another similar situation when Laura got treatment at Regenexx's Colorado facility. If you have someone who can travel with you to help, this problem is lessened but it is real and prior planning (as well as lots of posts asking for advice here) will help.


Getting back home from the surgery is the second major problem. There's a tendency to either rush the return trip and have to reschedule it when you aren't ready to travel as soon as you thought you were or to delay the return to the point where you start chafing at your time in the hotel and start overdoing because of boredom and cabin fever. Hopefully, you can talk with the proposed surgeon's office and get a good feel what the target departure should be. If you run late, don't be afraid to talk about the medical necessity with the airline if you need to change your ticket. Sometimes that's enough to get them to waive the change fee on your changed travel plans.


Finally, before you commit, spend time getting to know how easy it is to get the surgeon's office on the phone and getting answers from the surgeon. If it's hard before your surgery, don't use that surgeon. It will only be more difficult when you return home after the surgery and need answers RIGHT THEN because something about your recovery isn't matching what they told you should be happening.

Thanks so much for this Annapurna. Super helpful!

Although I live in the US I was born in the UK and have spent a lot of time in Europe including Germany so luckily navigating a new area shouldn’t be too difficult. Especially like you said with smart phones / internet now its quite easy.

Regarding the long flight I’m definitely a little concerned. I should be able to get a business class flight but even just LA to NY (or shorter) flights in the past couple years have been brutal and often set off an acute flair up especially if i don’t get a business upgrade with a flat bed. For that reason I’ve stopped traveling for the last 12 months whereas I used to have to fly often for work. I’m worried that the flight from LA to Germany will put me in a bad place going into a surgery. I don’t know if I should break it up with a stop in NYC or just bite the bullet and go direct to Europe.

Luckily I have family and a place to stay in the UK (or even NYC) and don’t have to return to work so I’m considering going there after surgery (If I decided to do in Germany) to rehab for a bit instead of making the long haul back to LA.

On the other hand there do seem to be some pretty experienced surgeons in LA these days with many having hundreds of ADR’s experience. I’m just concerned that I should be focused getting a newer type of disc esp since I’m so young. It’s all prodisk here except one doctor i’ve Spoken with who said he could use Activ L but I don’t think he has much experience with it.

Anyway I’m meeting with two more surgeons in LA and I’ve started the process of getting consults from Dr. Desai and Dr. Bertagnoli and Dr. Clavel.

One thing to think about on the long haul flight from LA to Europe vs. a stop in NYC: It's pretty easy to find an option for a fold-flat seat on the long-haul flight direct from the west coast of the US to Europe. I'm in the Pacific Northwest and have used British Air, Delta and Condor to get from the west coast to Europe. More on that following the countering option.


If, on the other hand, you try to add a stop in NYC, you might find it hard to find a fold-flat seat crossing the US. First class, reclining but not fold-flat, seats are the common offering.


On the thought of airlines: I don't know what you like in a airline seat. I don't sleep on planes so my needs are modest. That said, I really didn't find a major difference meeting my desires between the highest and middle class on British Air, Delta One (highest class) and Condor. Yes, the service, seat, and food was different but nothing that really impacted my ability to have a good flight. It's something to think about when you look for airlines to check into.


Really, the only one I'd argue against is Icelandair. They don't offer fold flat seats and have difficulties in dealing with customer problems in the satellite offices, typically handing off any concerns to when you reach Iceland.

One word
 

BERTAGNOLI 1 stop shop