[scotto74]

Hey everyone, sorry I haven't been on in awhile. Just wanted to provide a quick update...

Harrison -- I finally did check into that "brachial neuritis" thing with my doc at Penn. As I suspected, it was a coding thing. Cervical radiculopathy (which I have had on multiple occasions) and brachial neuritis have the same "ICD9 code" used by the radiology group at University of Pennsylvania. So, no brachial neuritis here thankfully! But it certainly was a good catch on your part!

I also wanted to close the loop on the Texas Back Institute issue. I finally was able to get a hold of someone at their office to discuss the "not surgically remediable" diagnosis. While I really pressed hard (in a very polite and thoughtful sort of way) for further information, I was told that by Texas law unless they actually see me for an office visit -- they can only say "yes" they think I am surgically remediable, or "no" they don't think they can help me surgically. I really pushed hard to try to further understand the reasoning behind their assesment of my case (as it might be helpful in my journey), but to no avail. I did infer, however, from the discussion that perhaps they thought I was not a good candidate for ADR and it would not make sense to travel all the way to TX for a fusion. Hence, the referral to a surgeon at the Rothman institute in Philadelphia. However, that's just a hunch from what I was able to discern from my conversation. So time to move on!

Well, I had two more surgical consults late last week. The first doc (Jason Cohen at Monmouth Medical Center, a really great guy) proposed a two-level fusion -- but interestingly said if I were 60 years old and had the same exact films he would recommend a four-level fusion, given the problems I have at every level in my neck. Then I met with Dr. Bitan in the afternoon. I really liked him alot. He also noted "wow, you have problems at every level in your neck" but thought it best to address the two levels where I have the most compression on my spinal cord first. He proposed the same surgery that Dr. Mummaneni at UCSF proposed -- a fusion at 6-7 and an ADR (Prodisc C) at 5-6.

I am leaning towards going with Dr. Bitan and am trying to go through the insurance approval process now (ugh). I liked that he proposed the same surgery as Dr. Mummaneni (who also has great credentials), and I also like the idea of at least one ADR at 5-6 as opposed to a two-level fusion. Perhaps most importantly, I like that he is alot closer to home -- only about an hour and a half up the highway or on the Amtrak. With the amount of problems I have throughout my neck and the likely need for additional surgeries in the coming years, I think it makes alot of sense to be relatively close to my surgeon (or at least it feels better to me).

I'm still somewhat apprehensive about the whole thing, given that I will likely need additional surgeries in the coming years -- but I know that I need to decompress my spinal cord relatively soon, which is starting to cause some problems with my legs and hands. However, everything I have heard about Dr. Bitan is very positive and he seems like a great surgeon. So at some point, you need to take a leap of faith (to some extent) and address the most severe problems relatively quickly.

Sorry for the long post -- hope everyone is doing well, and thanks again for all the support!!

Scott