Re-Introduction - JJames, 40
 

Hello all,

Although I log onto these boards almost daily, I thought that it would be prudent to re-introduce myself as I have failed to do anything much other than read & research in a very, very long time.

I am writing now, as I feel it is time that I do something surgically (even if it may be wrong). My long, ongoing, daily pain has completely and totally taken over my life. I am extremely fearful of what surgical options are even available for me. I have another appointment scheduled with Dr. Yue of Yale New Haven on April 12th. Since my attempts to get insurance to pay for the bi-level ADR he suggested have failed miserably, I am now addressing the possibility of the hybrid surgery. Any thoughts, suggestions, or opinions on this surgery would be greatly appreciated.

As my signature indicates, I have developed upper back/shoulder and neck pain in addition to my old issues (these newer pains started November 2009). Although my PC doctor suggested yet more PT for this, I began seeing a chiropractic doctor since Jan 2010. I really like this doctor, but I have come to realize that there is very little he can do for me. All the pains continue even with the daily doses of meds.

My greatest fears are of course the surgery itself, but additionally if my new upper back and neck pain could actually be related to additional disc troubles. I do know that only more MRIs and other tests will possibly determine such, but I am uncertain if I even really want to know!

Due to my many unanswered questions, lack of knowledge, depression and fears, etc. I guess I'm just seeking any advice which anyone with similar thoughts, symptoms, or surgeries (hybrid?) may have for me. I am also considering seeking out a chronic pain psychiatrist in hopes that someone can assist me in making the correct decision without the cloud of a life in pain and medications. That said, I believe I already know the answer: If this chronic pain has now completely consumed my life, placing constant and difficult strains on my family, my marriage, my finances, my job, and every other facet of every day life (more like "survival") something MUST be done.

Thank you all for any information or thoughts,
Jeff

JJames,

Sorry to hear about your condition. Seems you are getting what a lot of spinal patients get - the runaround!.

My wife is having a hybrid fusion ADR as we speak at Texas Back Institute in Plano (she's in the OR right now, I'm sitting the waiting room just wanting it to be over). We traveled from Alabama to have the surgery done here because they are among the best in the world at ADR and equally as expert at fusion technolgies.

Frankly we had the hybrid done because of cost reasons (insurance is paying for everything except the ADR hardware and the doctor's fee related to the ADR), and because according to Dr. Blumenthal there appears to be little difference in mobility and longer term outcome between 2 level ADR and hybrid fusion/ADR, especially at the L5-S1, L4-L5 levels.

Luckily she has not had any cervical spine issues...but hopefully these are not a problem - perhaps you just have pulled muscles/pinched nerves? But if they aren't getting better with anti inflammatories and other conservative treatments in my view you have to go have the tests to see if it is a disc related problem...

Anyway, feel free to post or PM me if you have questions about my wife's procedure, costs, etc.

Hope you find a path forward.

Thank you
 

Tigerpaw,

Thank you for the reply. Yeah, I am certain that I will not only need tests done regarding my new upper back and neck pain, but after so much time has passed likely my lumbar spine too. Damn, I hope I won't have to experience another discogram! Hopefully I will have some answers or direction after I meet with the surgeon.

For now, my heart is with you and your wife. I would be extremely interested to know how the recovery and or success of the hybrid method is since that at least seems to be my most likely surgical option. Again, I still won't really know until after meeting with the surgeon.

Again, the best of luck to both you and your wife.

Thanks again - Jeff

Welcome Back!
 

Dear Jeff,
Welcome back to the website. I know of the hopelessness and misery chronic pain can bring.....and I only had one level and no cervical issues. :Dead: I am sorry you are having so many problems. Last November I started seeing a PM out of desperation. I think you are on the right track, especially if you find a really good one that you like. This will help you make it through the days and possibly weeks and months until you can have your surgery. There is a lot to be said for that moment when you realize you HAVE TO DO SOMETHING. I am glad you have Tigerpaw and his wife to lean on for support and information. The hybrid surgery seems to have really good results. I just had one level ADR at Texas Back six weeks ago. I am NOT a clinical person but I have done TONS of research. As you know fusion has a bad rap because of the risk of adjacent level disease and lack of motion caused by the vertebra being fused. The hybrid seems great because the level directly above the fusion is protected. I have also heard a fusion at L5/S1 is not as bad because we do not have a lot of motion there anyway.

Good luck in your quest for some resolution. :oKeep us posted.

CD

Hi JJames!

I'm going to quote myself from one of my posting on here. This is when I went got my 3rd opinion with Dr Regan in Bev Hills Ca.

I was curious about the Hybrid and how that would work and if it would work for me at all. He told me that it is mainly done on people who have issues with L5-S1. Fusing that level and having a ADR at Level L4-5 seems to work well, due to the fact that there would be no disc below and the ADR above has movement. He told me that with my injury, I am in the middle with problems at L3-4; L4-5 and a hybrid is still a fusion and would strain the adjacent level.

I hope this can help some. While I was doing my own research I've read really good things about the hybrid. Based off what you said I think its a good option and worth looking into.

I wish you and your family the best of luck!

Liz

Appt Monday - Already Nervous
 

So my appointment with my surgeon is only a couple days away. I'm still so confused. In many ways I'm not even certain why I'm going back! As educational as all the information is on these boards, perhaps I should've stayed away from reading all the post-surgical ones.

If nothing else, I suppose it won't hurt to discover if the hybrid surgery is even a possible option for me (i.e. will medical insurance pay for it). Perhaps I won't really have any decision to make at all! So confused ....

Jeff

Hi Jeff,
I know Dr. Yue doesn't try to help people he can't and he doesn't make junk.

We have to turn over every stone in this search to get well and do our own homework. In the end the funnel narrows and we shoot out the other side so fast we wonder why the process took so long.

I sort of had the same choice S-1 fusion and L-5 prodisc. I understand from my discussion with Dr. Yue that sometimes fusion decisions must be made on the table anyway.

I choose 2 level ADR because Connecticut Workers Compensation was refusing to pay and I was sold on greater mobility and shorter recovery times.

Like yourself, I was in the hole all alone, never to think I would be in the position I am today feeling like 30 (and looking like 40ish according to feedback just yesterday).

If there was one pre-op question I would have dared to ask is whether or not he thought I could return to skiing double black diamonds in March or if lower fusion would have made it limited to blue intermediate.

Feel free to call me anytime.

I'm done
 

Thank you for posting a reply, Bill.
After my last visit with Dr. Yue, I think I'm through with him. He barely wanted to even discuss the hybrid surgery. A surgery which was only brought up by my wife and I. He wanted to do the bi-level ADR years ago when I saw him, and since I was denied by my med. insurance that was all. He did order the MRI on my cervical spine due to my new additional pain in my neck and right shoulder which radiates down my right arm. Although I haven't had the follow-up with him yet, it is apparent that I'm having more degenerative issues plus a "spur" and something called an osceophyte (sp?) in this area.

I give you and all the others on this site all the credit in the world for both your tenacity and courage. These are apparently something which I lack. I've now resolved myself to working more diligently on my coping skills, as I believe that coping with this life-long pain will be the best I can do. My next step is obvious - I am seeking out someone in the mental health field for assistance. I am also scheduled to see a rheumatoid doctor as that has been suggested to me by three of the other doctors I've seen.

I no longer view any surgical intervention as a logical choice, and I refuse to take such drastic measures simply because it sometimes appears to be the last or only choice.

Thank you and everyone else once again.

Jeff

My understanding is that "bone spur" = "osteophyte"

What do you think Yue's angle is? Is he just out for money? Or doesn't care much whether the outcome is good or bad?

The reason I ask is that I asked his opinion on my case and he's still a contender.

Dave

Tough question for me ..
 

Dave,

That's I hard question for me to answer. Mostly because he has not performed any surgery on me, so I cannot speak from personal experience. I have done much research and spoke to several other surgeons. He is very highly regarded, comes highly recommended, and has quite an impressive resume. Additionally, I do not consider myself very medically savvy or knowledgeable.

I think if (1) he had even tried to "convince" me that surgery was my best or even optimal option or (2) my medical insurance would've paid when he first proposed the bi-level ADR surgery after my second visit years ago, things would be a lot different now (for better or worse).

To me, any of the potential back surgery choices are a MAJOR decision. One which I would want to feel very comfortable was "right" and "appropriate" for my condition(s) and for my future. Based on my many appointments with Dr. Yue throughout these years, he has not done this.

I have been very frustrated at times due to waiting for months to get an appointment, making the trip of over an hour to his office, waiting for my turn, only to be rushed out of his office. I am almost always left with more unanswered questions when I leave, and even those which I manage to squeeze in are often brushed off. I have left many appointments feeling angry, frustrated, and confused.

I most certainly cannot speak poorly of his knowledge or skills as a surgeon. In fact, if I felt certain that there was a surgery which would help me I would still have him perform it even with all of my negative personal feelings. The problem is that he has never even tried to make me feel "good" about any surgical choice.

I suppose the bottom line is that if you are a surgical candidate, and it can be paid for (cash, insurance, etc.), he is probably a great choice. If there is not a straight line "appointment --> surgical decision --> patient willing and able --> surgery performed" he doesn't seem to want anything else to do with you. You become more of an annoyance than anything else.

Sorry for the length of this reply. I hope that my attempts to put my thoughts in writing have not misrepresented or confused things. I must admit, writing this rant has been somewhat helpful to me in an odd sort of way.

Best of luck to you!

Jeff