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  #11  
Old 12-01-2018, 04:15 PM
leipan71 leipan71 is offline
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Join Date: Nov 2018
Posts: 38
Default reference Dr Guyer

Thank you again for your advice. I am checking out how to contact Dr. Clavel's office and also find out Dr. Blumenthal is covered by my insurance. He and Dr. Guyer are both 2 hours away from me which is a huge blessings.

Once I have my discogram done, I can for sure consult Dr Blumenthal as well about the surgical plan. I also have received some high remarks from Dr. Guyer's former patients from this forum which is very encouraging. For me, if there is not a huge price difference, i would prefer to stay in the US just in case there is any issue after surgery.

Dr. Guyer has prescribed facet joint injection to rule out facet joint issues and then I will have a discogram and then a consultation right after. It will be in Jan due to the holiday season. I will update my situation once the surgical plan is out.

Thank you again for your advices and support. It means a lot to me.
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #12  
Old 12-02-2018, 05:36 AM
GravyBaby's Avatar
GravyBaby GravyBaby is offline
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Join Date: Mar 2018
Posts: 128
Default

You're welcome!

It sounds like you are taking things into your own hands now. I will be looking forward to hearing about your progress!

Best of luck!
__________________
2001 - Pulled off monkey bars, landed directly on coccyx.
2006 - Sports injury that made it worse.
2016 - Multiple instances of paralyzing low-back pain.
2017 - Blew out my back on leg-press. MRI showed L5-S-1 disc herniation and grade 1 retrolisthesis.
2018 - Successful ADR surgery with Dr. Rolando Garcia using the Activ-L implant.
2019 - In physical therapy for burning in feet, L4-L5 diffuse disc bulge and SI joint pain.

29 - Male - American
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  #13  
Old 01-02-2019, 01:56 PM
leipan71 leipan71 is offline
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Join Date: Nov 2018
Posts: 38
Default facet joint injection

Hi, I had my facet joint injection done on Dec 12, 2018 mostly as a diagnostic tool. I did not feel any improvement for the first 24 hrs and the later one week. However, i notice that I can stand and walk longer time now which is 2 weeks later. Yesterday, I even went to mall with my daughter walking around on and off for almost 2 and half hours. In the past, I could only walk about 45 mins top without too much pain. Of course, after the mall trip, I came home laying flat on my heating pad to reduce the pain which is very much expected.

When the doctor examined me asking me doing forward, backward and left, right bending, I did not have any extra pain. My pain is always related to walking and standing and some times sitting for too long. That is why doctor Guyer does not think my pain source is the facet joint but the degenerated discs. But he still wants me to do the injection to rule out. When I did not notice improvement right after the injection, I assumed that the pain is not facet joint related. Now, I am not so sure. Another reason is that I also went to NCY to see a surgeon for a second opinion. His name is Russel Huang. After he saw my MRI and X-ray, he concluded that he would not do anything for me since he thinks that my MRI does not look bad to the point that a surgery is needed. Maybe because of the reason that I had a discseel procedure early this year, I am having good disc height and mild bulging on the image.

I wonder whether anyone of you have the similar injection and how soon usually it shall start to work if you do have the facet problem. My discogram is scheduled 3 weeks later and I am going to see Dr. Guyer in two weeks. I am still debating whether I want to have the surgery at this point of my life.

Dr. Bertagnoli also gave me the estimate and diagnosis about two weeks ago. His diagnosis is very similar to Dr. Guyer's, a definite L5-Si ADR and a possible L4-L5 depending on the result of discogram. Dr. B will use prodisc. I will find out what Dr. Guyer would suggest when i meet with him in two weeks.
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #14  
Old 01-02-2019, 03:16 PM
leipan71 leipan71 is offline
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Join Date: Nov 2018
Posts: 38
Default Longevity of prodisc, or activ-L

There are several reasons that I am struggling with the decision of the surgery.

1) I am concerned about the longevity of the prodisc or activ-L if these are the discs I end of having. I am currently 48 years old. I don't know whether these discs can last for the rest of the life. If not, what are the solutions? (that would be the question I will also ask when I meet with Dr. Guyer)

2) Currently, due to the fact that I don't work, I can manage my pain level by not doing the things that will aggravate it, which are walking and standing on my feet. For instance, I can walk my dog for 30 mins and then lay down on my heating pad for relief of the pain. I manage not to take any pain med so far. If I have to do prolonged walking which is more than 1 or 2 hours, I always try to bring my wheel chair. If I travel, I always use my wheel chair for getting around. I gave up any sports such as tennis or running long time ago.

I guess sooner or later, I would have to have a surgery since it can only get worse. I just wonder postponing it for a while might give me more options? I will have a discussion with the doctor, but at the same time, I would love to hear what you guys think.
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #15  
Old 01-02-2019, 04:24 PM
annapurna annapurna is offline
Senior Member
 
Join Date: Dec 2004
Posts: 1,562
Default

Obviously, the Activ-L isn't old enough for its longevity in real life situations to be challenged. The Charite has been, though, and performed well for over 25 years since it's early days. Rich/Harrison, Laura, and Sir Alistair have all had theirs in for over 15 years. There are others but all three of those are of the same vintage so it's easier for me to talk about them.

Delaying surgery can make surgical intervention more difficult or render it impossible to resolve all of your pain once you do get surgery. The decision to pull the trigger is up to you but there's risks associated with going too early or with waiting too long.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #16  
Old 01-02-2019, 04:46 PM
leipan71 leipan71 is offline
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Join Date: Nov 2018
Posts: 38
Default right timing to get the surgery

Thank you so much for your insight. I guess the right timing is definitely the key which I am not sure of. Dr. Pauza who did the disc seel procedure on me commented that my discs don't look that bad compared to my age group. He is puzzled why I am having so much pain after the procedure. But Dr. Guyer thinks it is the discs that are causing the pain. I might need to get more opinions so that I can be more confident on my decisions.
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #17  
Old 01-04-2019, 11:56 AM
annapurna annapurna is offline
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Join Date: Dec 2004
Posts: 1,562
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This is from a while back but it's worth bringing up again. Zeegers came to the US west coast for a conference about ADR surgeries over a decade ago, back when sources of information like this board were few and far between. Because of that, many of the potential ADR patients attended conferences in hopes of learning about the state of the art ADRs and surgeries.

On one slide, Zeegers threw up a MRI image showing a patient with a horribly desiccated and collapsed disk immediately below another disk with an extremely mild bulge then challenged the audience to point out which of the two were causing the patient pain. The mild bulge was the source of all of the pain the patience experienced. His moral of the story: pathology isn't the best predictor of pain.

If you feel your disks hurt and you're willing to go through to make sure it isn't nerve impingement or facets, then seek treatment for the disks and don't buy in to a doctor telling you that they shouldn't hurt because they aren't "bad enough."
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog

Last edited by annapurna; 01-06-2019 at 06:24 PM. Reason: grammar correction
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  #18  
Old 01-08-2019, 11:02 AM
leipan71 leipan71 is offline
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Join Date: Nov 2018
Posts: 38
Default disc pain

Dear Annapurna,

Thank you so much for your input about Dr. Zeeger's lecture. It is very enlightening to me. I guess lots of the doctors have not realized this aspect of diagnosis yet. I went to a different doctor in NYC and I was told that my MRI really does not look bad. He told me that he won't be willing to do anything for me since he is not sure. From the image, the level of degeneration is concordant to average people in my age group. (I am 48) He also said that the discogram is not that reliable so that they don't really do many discogram. This doctor works at Hospital of Special Surgery in NYC.

I am going to see Dr. Guyer soon and I have tons of questions for him. After reading some of the failure cases, I am terrified. I will update once I have the consultation with him.

Thank you again for helping me out here.
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #19  
Old 01-09-2019, 11:10 AM
leipan71 leipan71 is offline
Member
 
Join Date: Nov 2018
Posts: 38
Default Do US doctors use adhesion barrier and Bone ceramics for ADR surgery?

Does anyone know that whether surgeons in Texas back Institute use specific techniques such as
1) adhesion barrier
2) AMP vertebroplasty (bone ceramics) if the bones are weak
3) thrombin agents to reduce surgical bleeding
4) bone wax to remodeled bone or adr preparation site to prevent osteophytes from forming?

I am going to have a consultation with Dr. Guyer in TBI. I am not sure whether it is rude to ask for the information since these are used by Dr. Bertagnoli in Germany.

Any info will be appreciated. Thank you!
__________________
started to have back pain at age of 18
DDD at L5-S1 at age of 23 in 1993
bulding discs and disc tear at L4-L5 and L5-S1 in 2017
DiscSeel procedure at L3-S1 in Feb 2018 (no help)
considering ADR at L4-L5 and L5-S1
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  #20  
Old 01-10-2019, 03:56 PM
Harrison's Avatar
Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 6,866
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Leipan,

It's been years since I was really close to the OR techniques, so I will only speculate based on what I learned from patients within this community.

1) adhesion barrier: the adage "less is more" fits here. Early on, meshes were used and some proved disastrous, complications and law suits followed.
2) AMP vertebroplasty (bone ceramics) if the bones are weak: if cracked, yes. But not for restoring bone mass or density. This is more popular with Euro surgeons.
3) thrombin agents to reduce surgical bleeding: not sure, but blood thickness/viscosity is carefully managed pre-op; any bleeding is obviously monitored and managed in the OR.
4) bone wax to remodeled bone or adr preparation site to prevent osteophytes from forming? Again, more of a Euro practice. Early on, there were infection problems.
__________________
"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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