New Here – 2nd Opinion Question
 

Hi everyone,
My name is David and I’m 54 years old. My adventure unknowingly started back in 2003. High calcium levels were noticed and I was checked out for Parathyroid disease. I was assured nothing was wrong. Broke a hammertoe on an elliptical in 2008. In 2009 and I was diagnosed as hypothyroid.No Hashimoto’s or Graves. I also had shoulder surgery (bone spurred the clavicle, 6 labral tears, cyst, sub acromial decompression). In 2011 I thought I tore the shoulder again and discovered the C4-C5 DDD and C5-C6- disc bulge. In 2012 the Parathyroid tumor was finally removed. In 2013 I did a 11+ mile run on an elliptical (70 minutes) and felt the pop in the back. That’s when lumbar problem was discovered. In 2014 I felt the shoulder pop again. This time Quadrilateral Space Syndrome.

I’ve had 3 cervical epidural’s, 2 lumbar epidural’s, PT (actually made things worse) and 3 years of chiro care.At this point not much helps. I take the naturopathic route and occasional ibuprofen to deal with pain. I’ve found this isn’t going to get better by itself.

I’ve declined the C4-C5-C6 fusion. TBI has recommended a hybrid C4-C5 fusion with C5-C6 ADR. I’ve been declined for the M6 trial due to multiple levels but was told I would be a good candidate for C4-C5 ADR.

I’m looking to get a couple more opinions here in the US. I don’t see Germany as an option although I love to go back to visit (I was there when Chernobyl blew up).

I’m inclined to get opinions from both Dr. Pettine and Dr. Wohns from what I’ve read so I can get a 1st hand impression.

Please comment on the following question

Do you get a better 2nd opinion by visiting the doctor in person or taking the out of state review at no cost?What has been the experience of people here?

Welcome David. Sorry to hear about your problems. I always felt better about the opinions through email or on the phone. I think that most doctors here, I have seen 7 so far, are all pretty much arrogant and are much more interested in going to a straight surgical route with fusion as that is the norm here and how they make the most money. I went to 4 doctors who specialize in ADR surgery, but wanted to do fusion anyway because I already had one. I believe that the fusion put me in the position of needing more surgery. I ended up going to Spain, and am very glad I did and would not hesitate to go back if needed. Have you had a bone density test done? I would do that first to make sure that you are a candidate for surgery. If you look for that in the forums, there are a number of posts about the reasons for getting the test done. I wish you good luck with your decisions.

David,

A benefit of multiple opinions, whether in person or absentia, is that you can see that the prescriptions converge and give you more confidence that you are pursuing the right course.

Good luck!

Dr. Wohns
 

Hi David,
Dr. Wohns is my Dr and I'm fortunate to live so close to him. From what I understand he will review your films but also wants to do a physical exam as part of his diagnosis and suggestions. Have you called him or sent your info there? I received several opinions, overseas and in the states even though my case was pretty obvious I wanted to see if everyone agreed.

Thanks for the replies.

I don't have a cervical bone density scan but I do have a lumbar bone density scan from 12/2013. My T score was 1.4 for L1-L4.

I plan on calling both Dr. Pettine and Dr. Wohns tomorrow.

Good luck. Dr. Pettine did my surgery back in Oct 2014 and I am very happy with my results. Please keep us updated.

I saw Dr P e t t I n e yesterday, I had new lumbar x-rays and learned something new. The radiologist that said I had Schmorl nodes..... well Dr P e t t I n e looked at the new x-rays, pointed out the deformities in the vertebrae and called it Junenile Discogenic Disease which is a genetic defect. My local Dr never told me I had a genetic issue. L5-S1 is nearly bone on bone now so no lumbar ADR as there is not enough space to insert a device. ALIF fusion is being recommended along with stem cells at 3 levels. Now for the cervical he is recommending a 2 level Mobi-C. I'm glad I made the effort to go see Dr P e t t I n e. I've got UHC with Care Plus. I've seen posts in the past that give me hope for approval on the 2 level ADR.

L5-s1 bone on bone prohibits ADR? Not enough space? Now I am really worried! I have pretty much the same but was hoping they could insert the disk anyway?

Romakis, all doctors seem to have a different protocol. Some will decline ADR if you've lost half of the disc height. One poster on this site had lost enough disc height that the edges of the adjacent vertebra had begun to fuse to each other. His surgeon cut the bones apart, cleaned them up and did an ADR. It just depends on your surgeon and what that surgeon has had good/bad luck with in the past.

Bone on bone is not ADR contraindicative. Facet arthrosis however is, I would assume beyond Modic 2.

I was L5/S1 bone on bone but fused for other reasons. But my other two levels above were both touching bone on the posterior edge. Two M6s later...