Formal Introduction

[TPatti]

After having discogram I am glad I cancelled surgery for L4/L5 fusion, I had more pain from L5/S1 and seems to me that there are more issues there from the report! Report attached.

[TPatti]

I have recommendations from Dr. Dare and Dr. Lauryssen. I am waiting for Dr. Clavel to review again now that he has my discogram with 4 view xray and contrast CT. Also waiting to meet Dr. Cappuccino, who I hear to be the only doctor to consider adr's in the Buffalo area. I will post all recommendations next week but decided to share the outcome of yesterdays visit with Dr. Hamill. To Dr. Hamill's credit, he was the only one who agreed that canceling my surgery to have L4/5 fused was the right decision. I had two surgeons give me the same diagnosis, and the one I had originally scheduled with told me that a discogram is not an accurate enough test to bother with as an aid to diagnosis. Dr. Hamill agreed with me that looking at the condition of S1/L5 it would be best to get a discogram to make sure that L4/5 was really the pain generator and that they were not possibly both generators. Test revealed level 2-3 pain at L3/4, level 6-7 pain at L4/5, and level 8-9 pain at S1/L5 - so I believe canceling the one level fusion at L4/5 seems to have been the right decision. My disappointment with Dr. Hamill comes from my follow up with him yesterday:

DOC: So about your disco gram report-pain at all three levels-you would need a 2 level fusion that would turn into a three level not far down the road-Iam a surgeon and I do not recommend you having surgery, the outcome for this type of surgery has a high percentage that you could be worse off after having.

ME: What about adr above 2 level fusion?

DOC: Statistics show increasing rates that adr's do not work

ME: What about comparing different manufactures adr's

DOC: They are the same, none of them work

ME: If my pain continues to get worse what is recommendation to deal with it

DOC: Changes your life as you need to, see your primary doc or pain management doc but stay away from narcotics and surgery. Let me know if you ever need anything else. Then leaves room

[CanadianDean]

Wow! I know you are getting other opinions and have consulted with other doc's. Understanding that not everyone is a candidate for surgery, fusion and or ADR it sounds like you have taken all the steps to determine where your pain is coming from. I had a neuro surgeon early on in my "back journey" tell me I would just have to live with my DDD disc and change my lifestyle and go on a pain management program (drugs for the rest of my life) and hope to one day do activities with my two boys. My wife was with me at that appointment and I remember sitting there thinking wtf this guy must be a smart guy given his qualifications and he's telling me this. Turns out your doc and he must have gone to the same school as he was a moron and was wrong. It motivated me and my wife to find out if there was a fix and I reached out to surgeons in the US and Europe and ended up finally meeting with the right surgeon here in Canada who basically told me he can fix me with ADR surgery. I'm not a doc and do not know enough about your situation however I wanted to share this story, even when I think about this now I get pissed off.
Take care,
Dean

[TPatti]

Thanks CD. Opinion from others are somewhat varied but have some consistencies. I agree that they must have gone to the same school. Once I have all recommendations back I will post with all together, I think this will be better that having info scattered thru various posts.

[jss]

Todd,

We are products of our experiences; and your doctor sounds to have had a lot of bad outcomes in spine surgery! Since he doesn't want to operate on you anyway, I think you both win.

Whew! Good call.

Jeff

[JeffR]

Man what a terrible bedside manner, just thank your lucky stars you didnt let that guy cut you open!

[Lillyth]

Oh. My. God. What a horrid person. Basically, don't ever do anything to help yourself. Just hurt forever. Yay.

[newleaseonlife]

Originally Posted by TPatti

I have recommendations from Dr. Dare and Dr. Lauryssen. I am waiting for Dr. Clavel to review again now that he has my discogram with 4 view xray and contrast CT. Also waiting to meet Dr. Cappuccino, who I hear to be the only doctor to consider adr's in the Buffalo area. I will post all recommendations next week but decided to share the outcome of yesterdays visit with Dr. Hamill. To Dr. Hamill's credit, he was the only one who agreed that canceling my surgery to have L4/5 fused was the right decision. I had two surgeons give me the same diagnosis, and the one I had originally scheduled with told me that a discogram is not an accurate enough test to bother with as an aid to diagnosis. Dr. Hamill agreed with me that looking at the condition of S1/L5 it would be best to get a discogram to make sure that L4/5 was really the pain generator and that they were not possibly both generators. Test revealed level 2-3 pain at L3/4, level 6-7 pain at L4/5, and level 8-9 pain at S1/L5 - so I believe canceling the one level fusion at L4/5 seems to have been the right decision. My disappointment with Dr. Hamill comes from my follow up with him yesterday:

DOC: So about your disco gram report-pain at all three levels-you would need a 2 level fusion that would turn into a three level not far down the road-Iam a surgeon and I do not recommend you having surgery, the outcome for this type of surgery has a high percentage that you could be worse off after having.

ME: What about adr above 2 level fusion?

DOC: Statistics show increasing rates that adr's do not work

ME: What about comparing different manufactures adr's

DOC: They are the same, none of them work

ME: If my pain continues to get worse what is recommendation to deal with it

DOC: Changes your life as you need to, see your primary doc or pain management doc but stay away from narcotics and surgery. Let me know if you ever need anything else. Then leaves room

Wow. Just wow. I am so sorry that was the response you got. Then again, I had a surgical consult where the doctor told me the pain was all in my head. I felt like snapping back with, "Clearly you weren't hearing me correctly. My head's fine, it's my neck and that's the issue!"

That being said, I've heard that Dr. Cappuccino is a wonderful surgeon. He works with AIMIS and can do surgeries in Cyprus. If he is local, it might be worth it to check with him. I did that with my ADR. My local surgeon did all the pre-op stuff, performed the surgery in Cyprus, and then did all my follow up care at home.

As for Drs. Dare and Clavel, I have heard great things from them here on the boards, but don't have any first-hand knowledge.

Please feel free to send me a PM if you would like to know more about my surgical experience or you would just like to vent.

[TPatti]

I met Dr. Cappuccino last Monday. It was a breath of fresh air, finally a local doc who spoke the same language as the European docs. He told me canceling the surgery for one level fusion was one of the best decisions of my life. He agreed that Dr. Hamill was at least right in the fact that I would be worse with a 3 level fusion and that is road I would have been headed down if I went thru with the L4/L5 fusion. He said that I was right in that I needed to go to Europe and that he could help because he is part of AIMISS. He work closely with Dr. Pimenta as well!

He is concerned about facet joints and end plates at L4/L5 and had me get a more detailed CT scan and I go for nuclear bone scan tomorrow. I will be forwarding info to Dr. Clavel as well and figure that it will be Cappuccino, Pimenta, or Clavel performing surgery. My only concern is that if I wanted to lean toward Clavel because he has more experience with the M6 I am not positive Dr. Cappuccino will follow up with me or not.

This is important because I cannot find a primary doctor willing to be part of follow up to prescribe pain med.'s and fu images. Dr. Cappuccino also mentioned that he is not sure if I should go with Kineflex or M6 disc because of concern of longevity seeing that I am 42. He thinks there may be some advantages of longevity with a metal on metal disc and still has concern of "plastic" materials breaking down over time. I am concerned that 2 or 3 level of no shock absorption could be an issue as well, he did agree that we should look into further and would also discuss with Dr. Pimenta.

I am taking it one step at a time and trying to cross each hurdle as it comes. Dr. cappuccino spent 2 hours with my wife and I and was very pleasant and easy to talk to. If you are in the Western New York area I would recommend him as the only spine doctor to see, trust me, I've seen the rest.

[Lillyth]

Originally Posted by TPatti

I met Dr. Cappuccino last Monday. It was a breath of fresh air, finally a local doc who spoke the same language as the European docs. He told me canceling the surgery for one level fusion was one of the best decisions of my life. He agreed that Dr. Hamill was at least right in the fact that I would be worse with a 3 level fusion and that is road I would have been headed down if I went thru with the L4/L5 fusion. He said that I was right in that I needed to go to Europe and that he could help because he is part of AIMISS. He work closely with Dr. Pimenta as well!

He is concerned about facet joints and end plates at L4/L5 and had me get a more detailed CT scan and I go for nuclear bone scan tomorrow. I will be forwarding info to Dr. Clavel as well and figure that it will be Cappuccino, Pimenta, or Clavel performing surgery. My only concern is that if I wanted to lean toward Clavel because he has more experience with the M6 I am not positive Dr. Cappuccino will follow up with me or not.

This is important because I cannot find a primary doctor willing to be part of follow up to prescribe pain med.'s and fu images. Dr. Cappuccino also mentioned that he is not sure if I should go with Kineflex or M6 disc because of concern of longevity seeing that I am 42. He thinks there may be some advantages of longevity with a metal on metal disc and still has concern of "plastic" materials breaking down over time. I am concerned that 2 or 3 level of no shock absorption could be an issue as well, he did agree that we should look into further and would also discuss with Dr. Pimenta.

I am taking it one step at a time and trying to cross each hurdle as it comes. Dr. cappuccino spent 2 hours with my wife and I and was very pleasant and easy to talk to. If you are in the Western New York area I would recommend him as the only spine doctor to see, trust me, I've seen the rest.

If it helps, Dr. Clavel said the plastic in the M6 is sheathed in a material that does not break down.