New Here...
 

Hi, Im new here an have been trying to do lots of researching about total disc replacement. wow lots of stuff yet I seem to be having trouble acually finding Dr's here in the US that do them. I was looking into Dr. Ritter Lang but I have read about to many people not being happy, and the cost with him was starting at 36K wow. Hopefully some of you can give me more info on Dr's here and in other countries that i can look into.

Thanks, and all info advice experience is appreciated.

ALso I was diagnosed with MS some 12 yrs ago and I have never had any clinical signs so i am somewhat concerned of that, would really stink if this surgery triggered it lol. I also have BCBS of alabama has anyone had any luck gettting them to pay? It is not covered but I read some people get a lawyer and then some insurance have paid.

Shot
 

Well Dr. wanted to try doing the shot on my L3-L4 disc seeing that on the disc-gram it showed that it was much worse than the L5-S1(that is the one I had had shots in previously) so had it done on Frid. going througth the few days of lots more pain, who knows maybe i will get some relief lol. Talked to the Dr. then and told him I wanted a second opion on the disc. of course then also wanted his opinion an any Dr. who do the disc re-placement. ( just wondering if he knew some) he did say that there was a Dr. in ALabama doing them now, I dont remember what he said his name was but will find out more when I go back for my check up in a few weeks.

Ally, sorry for the delay, I hope we can help you with your next steps. We recently had a discussion topic on MS, did you see that? I'll chime in later...

Here are the MS-related topics. There are more, but here are the ones I recall:

http://www.adrsupport.org/forums/f58...atients-11645/

Bartonella Bacteremia and Rheumatic Symptoms
http://www.adrsupport.org/forums/f50...symptoms-11636

Cervical C5-C6 Pro-Disc C - Tumblebug
http://www.adrsupport.org/forums/f47...mblebug-11203/

Nerve damage or MS?
http://www.adrsupport.org/forums/f44...amage-ms-9823/

http://www.adrsupport.org/forums/f48...myelitis-9831/

MS
 

Thank you for posting those for me.

You know its sad when you go for your second opinion and that Dr. just barely looks at your file, and proceeds to tell you things on your disco-gram that are not even true. He stated that my good disc that was in-between the two bad ones, showed that I had pain lol, no it didnt. Also said that my L4L3 disc was not leaking it was the L5S1, and that is also un-true. Geeeesh come on Dr's read your patients file.

I took my sister with me because she is a nurse and he wouldnt even recogonize anything she asked. What a waste of time of an araogant Dr. who showed me that he really didnt much care for my well-being.

On another note I have gotten my records together and i am sending them to the Texas Back Institute and hopefully Dr. CLavel also.

Ally

Discography is OK, a part of standard procedure for many surgeons. I had a discography performed. Please note that not all surgeons believe in the use of discography and several advocate questions around the procedure. Discography may give false positives (see pubmed: Discography+Carragee). The bottom line is discography is a diagnostic.

Ideally you get Yes / No, or binary answers, but these may be rare. Ideally the doctor / surgeon will have completely read your file, but may not have enough time in the day. Surgical opinons also differ sometimes given the same symptoms and diagnostics (discography, MRI). I had 3 or 4 different surgical opinons.

Let's move on productively to make use of your time with your sister at the last surgeon. Please ask for a written report from your last surgeon / doctor so you have a record in your file of what he/she thinks is best for your treatment based on their diagnosis. The last surgeon may have seen the MRI's in a different perspective with a better interpretation than the first surgeon.

One surgeon I saw walked/talked me through the MRI's showing me the picture attributes that corresponded to symptoms. The MRI report from the radiologist interpreting the MRI did not include the majority of that surgeon's comments. That's no surprise, not enough time or paper on the planet to comment / fully write-up everything. Your last surgeon visit may provide more depth of understanding on your situation.

Metabolic markers for discogenic back pain may include (2008 Keshari)
+ Lactic Acid and
+ Proteoglycan Mix

Standard MRI will not see these metabolic markers in the disk. Standard MRI will give a Pfirrmann score, see if you can find that on your MRI report. Your MRI report should also by in your personal files for reference.

A special MRI, T1rho, may help with the metabolic markers. See "In vivo intervertebral disc characterization using magnetic resonance spectroscopy and T1ρ imaging: association with discography and Oswestry Disability Index and Short Form-36 Health Survey." (2012 Spine Link Pubmed)

May I suggest if you have the time, motivation, possibly email or call Nocimed www.nocimed.com to see if their software is installed at an MRI facility in your area for testing. It will most likely be at a teaching or research hospital. Please note: Nociscan™ is restricted by Federal Law to investigational use. Nociscan™ is investigational only and not available for sale or use within or outside of the United States. (July 8, 2019)




slackwater_sf

Ally, I hope you make progress in the days ahead. Perhaps it was helpful to know that your last visit, though a bummer, was decisive. If docs don't inspire trust -- and don't support an educated patient -- who would want them?!

Nice post Steve, thanks for helping others. You rock.

Thank you for your comments, very helpful.

As for that any Dr. having time to read your entire file i agree that may be asking alot depending on how big it is. I had not picked up my copy of the what the Dr. wrote on my diso-gram till after I saw him, but when i took , what 2-3 minutes to read it , it plainly said disc. L4L5 no pain, so that is what I was mostly upset about, well and of course his not wanting to talk to my sister sitting right beside me. I always take her when i can if it is for something this important, she knows alot more questions to ask that I.

My MRI apparently did not show much at all, so this is why they sent me for a disco-gram. He basically told me nothing can be done go home and try to live your life LOL, I understand that fusion is not an option in my case because there is a good disc in-between the two bad ones, but when I mentioned that I was interested in a disc replacement all I got from both Dr.s I have seen so far is , they dont recommend them. So i just didnt say anymore to them about it as they were negitive. Oh well differant Dr. differant day lol......

ally,

i also had a relatively unimpressive MRI except that the internal disc structure was clearly off, which, along with my symptoms and diagnostic acumen of my pain dr at the time (whom i miss dearly and may well travel to see if i need him again!), led to my positive discogram at L5/S1.

i was lucky to have just 1 disc involved... just wanted to share though, my situation was similar and one of the orthos i saw was kind of like the doc you mentioned. said there was nothing to do, didn't recommend surgery... obviously we aren't the same person, but having that disc out got rid of my pain immediately.

good luck to you. feel free to email me at the email below since my PM box is full.