[annapurna]

1) There's been debate on whether you need a discogram if you're radiographically and pain/enervation symptomatic at a level. Feel free to push back on the need for a discogram on any level where it's plainly apparent intervention is required. If you're equivocal on X-ray, MRI, and examination, then the discogram or something to further assess you is probably worthwhile. There's also a body of evidence that a discogram into a borderline disk will push it over and encourage it towards DDD.


2) Obviously, we think well of Bertagnoli given that he put in both of Laura's cervical ADRs. Quality and skill in lining up multiple ADRs is critical. It's worth saying that, about a decade ago when Laura was needing ADRs, Zeegers said that Bertagnoli was the only surgeon he, Zeegers, would trust to put multiple ADRs into his own spine and Bertagnoli returned the compliment, albeit in separate conversations with us. Just because someone's experienced with single level ADRs doesn't mean they can do multi-level ADRs.


3) Way back when, we were able to wire money directly to ProSpine's account without the need for a middleman. In the intervening years, we've heard that the middleman is now required. If you're comfortable and your bank is comfortable with handling wire transfers, you might see if you can skip the middleman and go directly to ProSpine's account.


4) I'm not going to tell you that you should get a second opinion but, if your pain and disability level is such that you can wait for the 2nd opinion, it often helps. There are poster after poster who got very different opinions about what needed to be done when they saw different doctors. Sorting that out can be really difficult but it also points out whether you're clearly in need of surgery at every level or over the line on some and borderline on others.