San Francisco - ADR physical therapist and pain management doc?

[Liz]

I know there are several people in San Francisco on this forum so I wanted to see if anyone could recommend a good physical therapist that has experience dealing with ADR clients post-op. I've been through numerous PTs in the Bay Area over the years and none have experience with ADR. I'm thinking about trying St. Marys since they work with some of Dr. Zucherman's patients but any referrals would be appreciated. I'm planning to start PT after I get the OK from my surgeon in a few wks.

Also any referrals to a good pain management doctor would be helpful.

Thanks so much for your help! Feel free to PM me.

Liz

[CharlesinCharge]

Liz,

Finding a good PT that has ADR experience in the Bay Area is difficult. I live just outside San Francisco, and after my ADR surgery in 2006 I was not able to find one. However, I can recommend a great Pain Management doctor that I have used for the past year. His name is Adrian Bartoli and he is located at St. Luke's Hospital in S.F. (he also works out of the East Bay in Concord). His phone number is (415) 509-6123. He has helped me tremendously in my ongoing recovery from my ADR surgery.

[Slackwater]

Originally posted by Liz:
I know there are several people in San Francisco on this forum so I wanted to see if anyone could recommend a good physical therapist that has experience dealing with ADR clients post-op. I've been through numerous PTs in the Bay Area over the years and none have experience with ADR. I'm thinking about trying St. Marys since they work with some of Dr. Zucherman's patients but any referrals would be appreciated. I'm planning to start PT after I get the OK from my surgeon in a few wks.

Also any referrals to a good pain management doctor would be helpful.

Liz

Pain mgmt doctor, no data.

PT after ADR, suggest you are on the right track with St. Mary's SF since they do ADR/TDR work.

UCSF is another ADR/TDR site. I heard Nancy Byl, Ph.D., M.S. of UCSF speak about Physical Therapy before/after surgery last June 2007. I do not have her direct contact information. May I suggest calling UCSF Ortho/Spine Center and asking for an appointment. My thinking is get the PT plan / template from UCSF (or St. Mary's), activities may be similar to other surgeries, and arrange a briefing time with your local Physical Therapist.

You know the routine, bring MRI's, doctor reports, ...

Don't know how far away you are from SF. St. Mary's or UCSF is a drive, bridge traffic, just to get into San Francisco.

PT Specialties, Pleasanton, CA ( http://www.pt-specialties.com )shared they had one (1) patient with an ADR from a local hospital. I did not ask if they "modified" their program for that patient. PT Specialties has a pool.

[lizey p.]

I've been in pain management treatment for 3 years and have been in and out of physical therapy for even longer, over the course of my 5 year struggle.

I have a great pain doc at St. Luke's Pain Center. His name is Adrian Bartoli and he's the most accessible doctor I've ever had. He gives you his cell number and actually answers it when you call. I tried other pain docs and he was the only one who really heard me and worked with me for nearly a year and a half to find a regimen that would help me. I can't recommend him highly enough. Tell him Eliza sent you.

My favorite physical therapist is Pinder Badwan at CPMC Davies in the Castro. She books up about 3 weeks in advance for a reason. An athlete and former patient herself, she's been through rehab herself so totally gets it. Her approach has a lot of yoga and pilates-like elements to it. Tell her I sent you. She treated me before and after my 3-level ADR and has had plenty of experience with DDD and other spinal issues.

The best of luck to you!

[Liz]

Charles, Slackwater and Eliza - thank you for all the recommendations and leads... I really appreciate it.

Since two of you highly recommend Dr. Bartoli I spoke w/him today and I'm seeing him in a few wks.

Unfortunately Pinder is not accepting new patients b/c CPMC is not sure if she is leaving CPMC or not. A nurse from UCSF also recommended Pinder.

I live in SF... I'll pursue Nancy Byl w/UCSF and also St. Mary's. I saw Dr. Bradford at UCSF for several yrs until he retired. I also just heard about Proactive Therapy on Fillmore/Geary in SF that has worked w/ADR patients.

If I find a good PT to work with, preferably one that does manual work, I'll let you know.

Eliza - i'm impressed you got 85% pain reduction -- that's great! I was told I'd maybe get 50% mainly b/c i have other pathologies going on but i'd be happy w/that.

All the best,
Liz

[ZorroSF]

I have to jump in here. I have been negligent on this board and haven't added my 2 cents in quite a while. I've had nothing but major issues since I came to LA. I won't get into them here.

What I want to say is that nobody in San Francisco is going to cure you. You have to take charge of your situation and bring testing results back to this board and have other patients peruse your ailments. Then you need to take that summation and find the right doctor who can treat you. Zucherman doesn't do any serious testing on patients. he'll take an x-ray and look at an old MRI, but he won't spend any time with you to make the right decision. you're going to have to go elsewhere to find a better decision maker. He can correctly position the ADR device, but that's about all the info you'll get from him. And if you turn out to be anything other than greatful, he'll push you off onto another doctor.

DO NOT RUSH INTO ADR WITHOUT EXTENSIVE TESTING. you will regret it 100%. I know I did.

First you need to see a physical therapist. I went to three different locations and only one had a clue, but they had some issues running their PT business. I suggest seeing Red Hawk Physical therapy and ask for the most experienced therapist. I forget her name, but she has a dance/choreography background. She can make a very good assessment and has had minor experience with ADR and fusion patients. Additionally make sure your physical therapist assistant is Wayne or Lucia. if you get anybody else you're wasting time and money. only those two know how to perform exercises excellently.

I've experienced horrible inadequacies in the SF medical system. From the spine doctor to the physical therapist. In my case I had adult onset scoliosis and I should've been ruled out for ADR. Instead zuchermann's lack interest in testing has now left me with bad facet degeration at multiple levels and my neck is killing me. This was not the case before surgery. If you have an S in your spine, ADR is not for you. This is something that can be seen in an xray or MRI.

If you have no major muscle imbalances and no adult onset scoliosis, then you're still a candidate. If you have any facet degeneration, you should'nt be a candidate. If someone says you are then you're chances of facet degeneration increase greatly post-op. And I have to tell you, no doctor really cares in your predicament because once the damage is done there's really not a whole lot they can do to help you except push pills on you or try revision surgery.

Find the best PT you can to assess your muscle imbalances. find which muscles are firing and which aren't. you're PT can deduce your range of motion and localize the issues you have. This can better assist you in determining whether you can be helped by ADR or whether you need a fusion.

whichever you decide, make sure you follow through with PT for one year post-op. Also if you're doctor dismisses you or doesn't contact your physical therapist then you need to find someone else. Surgery isn't a cure, it's a fix and the follow up is what cures you. For some it only takes 6 months, but for most of us it can take years.

sorry for the long winded response. I really regret my surgery as you can tell, but I can only blame myself. I had no idea of the condition of the american medical system and what a racket it turned into.

[CharlesinCharge]

Not sure how ADR surgery or Dr. Zucherman screwed up your neck, but I live in San Francisco and I have never gone to see him (despite the fact that he is known as a world class back surgeon) because of some of the issues you bring up. Its takes months to get an appointment with him, and then I was told he only sees you for 5 minutes. Several patients told me he is very arrogant and has a terrible "bedside manner", and since I already had my surgery thats the last thing I need.

I had my surgery in Germany, but I don't doubt that many doctors there also will look at an MRI and an X-Ray and if you have DDD then they are ready to perform ADR surgery on you. They do not do an exhaustive study to see if you have excluding factors, because they stand to make thousands of dollars for every American patient that comes over and has surgery. I now realize that I was one of the ones that got lucky---I just as easily could have ended up like Anastasia or Blair or Joeytoey's wife or ZorroSF or Linda or the many, many others who have had ADR surgery and then found themselves in horrible pain. The bottom line is that ADR is NOT the "silver bullet" cure for DDD that many people thought it was when it first came out, and proper patient selection is critical. And even with proper patient selection (as in the case of Joeytoey's wife), things can go horribly wrong. It will probably be 25 more years before we really know how well ADR works.

[Harrison]

Originally posted by CharlesinCharge:
It will probably be 25 more years before we really know how well ADR works.

Good gosh, Charles, we CANNOT wait that long! Do you really think the diagnostics required will take that long to be put into use? I hope not. All spine patients will benefit - not just ADR patients. I see similar post-op issues with fusion patients too. It's very frustrating to see and experience.

[ZorroSF]

My lumbar facet degeneration created by the prodisc has put excessive strain on the muscles surrounding my cercival discs. There's plenty of muscle imbalance just to keep my head upright. I am now losing water in one of the cervical discs. the neck pain is as bad if not worse than the facet pain in my lumbar. I cannot sit, much less ride in a car for half an hour. this includes buses.

I think patient selection is quite easy. It just takes significant about of testing and observation on behalf of the surgeon. I believe you can also tell who will have a rough ride post-op. a lot shows up in the MRI and x-rays.

I'm just now learning so much about this. wish I was more proactive prior to surgery.

[Liz]

zorro, i'm so sorry that you're not doing well and i hope you can find some pain relief.

unfortunately as noted in my signature i had a 2 level prodisc 4 months ago. i'm having a difficult recovery which is why the request for a good pain management doc and PT in SF. if i knew what i know now, i would have postponed surgery as i have a clear scoliosis (one can see my backward S thorocolumbar scoliosis just by my slightly bending forward w/a prominent right rib hump; VERY obvious on an x-ray). i was diagnosed w/scoliosis when i was 10 or 11, wore a brace, and have struggled w/the resulting muscular imbalances for yrs but that did not limit my extremely active life until i decided to switch from skiing to snowboarding in 1998 and repeatedly fall on my tailbone learning.
four surgeons, including Dr. Zucherman, 2 surgeons at UCSF, and Dr. Delamartar, told me that I "should" be fine with the 2 prodiscs and my scoliosis. i also have some facet degeneration. although i only saw him once, dr. zucherman did take a long time to talk w/me when i saw him. he now advocates the flexicore over the prodisc though b/c he feels that it wears less on the facets.

thus far, my pain is worse although different than pre-op and i'm hoping it's still just early days. i'm interested in what you said about your new neck pain post-op b/c i've been getting daily migraines (although i've struggled w/them most of my life) and i wondered if the increase were a result of the inch in height in my spine. my scoliosis also curves in my neck. i've never had a cervical MRI, only MRIs/MRA of my brain for migraines. my arm went numb when i was in 3rd grade from a headache, parents took me to a neurologist for multiple tests, and i was diagnosed w/migraines. some are muscular, while others result from a myriad of causes.

thanks for the PT rec... i've seen the owner of Red Hawk (Harvey) pre-op, but he's only dealt with one ADR patient. he, like all PTs i saw pre-op, only made my symptoms worse and therefore wanted to stop seeing me.

charles, glad you are doing well.

i see my surgeon next week and will go from there.

best,
liz