Confused

[2Confused]

Hopefully, I am doing this correctly!

The information here is very helpful... I have been reading many of the posts & see that most are encouraging but there still is some question in my mind about ADR.
My neck pain is the result of an auto accident. I was rear ended by a large pick up truck that was traveling about 55mph. I sitting, stopped while a car was turning. My large SUV was pushed into another truck & we both were pushed 30 - 50 feet.
I have tried everything since the accident in 2009, PT, exercise, massage, chiro, pain managment.... Dr. initially recommended ADR. I have a ruptured disk C5-6 and stenois 6-7. Now, after giving it my best shot, trying every alternative to surgery, he is saying ADR & a fusion.
There is constant pain, sometimes worse than others... my arms have the tingling & burning, often they become numb feeling. My leg also has tingling & burning & has "given out" on several occasions. Headaches, a dull headache which can become a pounding headache if I over use my neck.

****edit

Dr says tha a double ADR cannot be done??

[annapurna]

There's no problem with doing a double ADR, ADR and fusion hybrid, or sequence of ADRs and fusions if, and that's a big if, your spine is in shape to take them. You don't have enough in your post to be sure but there are definitive reasons why a given level couldn't take an ADR and many, many reasons why an ADR might not be a best choice for a given level. Without belaboring this beyond reason, is the doctor saying you can't get a double level ADR or that double level ADRs can't ever be done on anyone?

We've encountered quite a few doctors who were simply not good enough to warrant how arrogant they were [only two types of doctors: those who are good enough to be as arrogant as they are and those who aren't. Though, I'll admit the same thing could be said of engineers]. One proceeded to inform Laura that ADRs could never exist; this took place about 5 months after her L5S1 Charite surgery so it was unusually comical. Double level cervical ADRs have been performed and the patients have posted here and were doing well as of their last posting. You can also find posters who didn't do well but that's the real risk involved in anything like this.

[2Confused]

Basically, my understanding was that you could not do a double ADR. He has suggested ADR & fusion.


I never had experienced neck pain before the accident & have tried everything to avoid surgery. I'm healthy & was very active prior to accident. Surgery is a very terrifying thing, since I've been so healthy & never had anything more severe than my wisdom teeth extracted. But living in pain is not a good life.

Here are more details, what other info is needed?

I'm looking up Charite.... most of these terms are new to me!



Cervical
Disk Rupture at 5 -6, and degenerative changes.
focal disk ruputure at 4-5,
paracentral disk herniation 3-4
A bone spur has now developed at C6
Bulging Disk at 6-7, slight cord compression

He said that a reversal of the curve (from whiplash?) is causing degeneration.

[annapurna]

Right now, it doesn't look like you have any major problems that would immediately prevent a double ADR. This doc may not do them, your insurance may not pay for it, and you might need to head out of the country to get the FDA's fingers out of your treatment protocol but you could get one. I do wonder, though, why he's talking about a double level when you have four affected levels. Surgery may not be indicated for all four but he should be talking about some kind of treatment plan for the ones he's not willing to replace.

[2Confused]

Thank you for your response. Honestly, I had not thought to question why there was not a plan for all areas that are damaged, thank you for pointing this out to me. * Frankly, I'm not thrilled with the medical care I have thus far received. *I used to joke & said more than once "if I had a serious medical condition to get me out of this area if they want me to recover". *
Not a funny joke, but a valid concern.*

On my last visit the doctor indicated that I should schedule surgery sooner rather later. *He said that the damages are progressing & causing more degeneration & that it would get worse if I continue to wait.

My spouse & I have discussed going to another area for another opinion. *My doctor at Mayo Clinic did review the first set of MRI's & CT scans & she indicated that I would need surgery, although this is out of her area of expertise.

I'm reading & researching the forum, so bear with me as attempt to absorb everything. *You mention Europe & from what I've read thus far here, they are light years ahead of us... Why? *FDA restrictions? *There is so much to learn & educating myself will hopefully ease my fears. *Recently, a friend who is older had back surgery - supposed to be a routine procedure, in & out in of hospital in 2 poss. 3 days. *Complications caused them to be in ICU for almost 2 weeks plus another week after.... So I am a more than a little afraid. *Plus, they are still experiencing back pain 5 months later. *

Again, thank you for your input - you have prompted me to ask more questions. *

Any advise & knowledge you wish to share will be greatly appreciated.

[Harrison]

Hi, welcome, sorry you are here. thx for creating a signature, did you watch the DVD yet?

ADR has been practiced in Europe since the mid 1980s, since 2000 in the U.S. More later, pls see all the different forums to get acquainted with the posts since 2004. The search function works well too.

I'd like to offer more help but I am swamped the next few months. The people in this community are really helpful...

[2Confused]

Thank you for your help today! No I have not watched the video yet, but I will. Where do I find it?

I am mostly bouncing around exploring & looking up the meaning to some of the medical terms.

Annapura turned on a "light" in my head... making a very valid point as to why the Dr. has not mapped out a treatment plan for the other areas of concern.

Thank you for providing this valuable forum! I have so much to learn & a lot of research to do.

[annapurna]

First, to head off potential arguments I want to say that there are excellent US docs and lousy European docs. One continent doesn't have a monopoly on either good or bad medicine. The first real ADR was the Charite, since taken off the market. It was developed over 20 years ago in Germany. The Charite was approved in the US about seven years ago. That's the first real benefit that Europe has over the US. The devices have been available there longer. The FDA is slower to approve medical devices and our insurance system places a huge impediment in the way of any kind of medical progress. I'll just state that baldly as the discussion of why would take a whole separate forum, much less thread.

If you can find a US doc willing to treat your whole condition and you can verify his/her skill and experience to your satisfaction, more power to you. If you can get your insurance company to cover the surgery, please post how you managed to get that major miracle to occur. Most of the forum will recommend you for sainthood if your method ended up working for others.

That said, a whole lot of the US patients going overseas are now doing so because they can't get what they need in the US or can't afford to pay US hospital costs after their insurance company refuses to cover any part of the operation(s). Laura was different as we went overseas back before the ADRs were approved in the US. European surgeons often do have an edge on US surgeons on tricky work, multiple levels, or combinations of ADRs, fusions, and non-surgical options. You can find a US surgeon that could do any one of them but not too many that have the experience in combining them.

MOST IMPORTANT ADVICE I CAN OFFER: It's your back and your health; don't let the doctor or surgeon refuse to answer your questions or buffalo you into something you're not comfortable with. You need to get into the driver's seat on this and accept the doctor or surgeon as if they were the skilled navigator. They tell you what can be done and where you'll need to go but you ultimately need to make the decisions. I don't doubt that you're doing that but I wanted to make sure it gets said so you know that you're doing the right thing.

Because Laura's spine adventures started so long ago, it's not fair to post details of all of the idiots she tried to get help her; they might have improved with time. I will say that we saw at least a dozen docs of different types before settling on a small number of docs who'd work with us. My rule of thumb was to see what the doc thought of us being knowledgeable patients. If the doc wanted dumb patients, we didn't want to work with them. I wasn't trying to impress anyone with our knowledge but if I asked a reasonable question based on what I'd learned and the doc didn't like that I knew enough to ask the question, I counted that visit as over.

Your doctor is probably right in suggesting that a plan of action should be formulated and followed somewhat quickly. If you are degenerating, you could reach the point where nerve damage becomes permanent and surgery would not do much for your pain. On the other hand, this is the time to measure twice before cutting once. The wrong surgery will land you in more problems than simply waiting. I'd suggest aggressively searching on this board and others to see if there are any good spine surgeons in your area. At the same time, try to gather all of your imaging studies and medical records so that you have the option of sending them overseas and/or hand carrying them to a surgeon in your area. I'd also take a hard look at how well you travel. If a hour in the car is agony, a ten hour flight to Europe is probably not going to happen. If you can handle a car trip, even on meds, you might expand the area you consider local to see if there's somebody around you that will work with you. You'll need that for follow-up, even if you do decide to go overseas. Lastly, you could consider the US spine centers like Texas Back. As the joke goes, some people swear by them, some people swear at them. They'd likely be a plane flight for you but it might make you feel more at home if the idea of a European medical vacation is daunting.

[Harrison]

Thank you Jim, Laura -- so helpful; to all. I am pretty sure that everyone appreciates your caring and articulate posts. Your most important advice is golden!

2Confused, see this link for the video:

Arthroplasty Video

If you have any question or problems, I am tech support among many other things...just send me a private message.

[2Confused]

Annapura,

Several questions come to mind, but I will not burden you with them! Obviously I have a lot of research to do & decisions to make.

I have looked online trying to find "Doctor Ratings". It seems that there is no "openness" regarding Doctors and any malpractice they may have been involved in. There should be a Doctor Report Card system of some type available to the public.... IMHO. My Doctor has the best reputation in this area... but as I said before I don't have a lot of confidence in this area!

Insurance - I wonder if that is why my Dr. says that 2 replacements cannot be done. My insurance company has always paid what I thought they should, but then I've never had anything prior to this that was a major expense for them. I've been lucky to be healthy...

You have given me a lot to ponder....
I will send you a private message to address a couple of things.
Thank you!