Has anyone heard of a Dr. Naraghi in San Francisco.

[Westwind]

I found Dr. Naraghi in San Francisco in my research. He is supposed to have extensive experience with ADR, both cervical and lumbar. So far, I have not found any negative info on him, but I see that no one has made mention of him here.

Here are two websites that talk about him:
http://www.spineuniverse.com/mdpage.php?doctorID=317
http://www.spineresource.com/8269/1.htm

I talked been in touch with Dr. Delamarter's office and sent them my films and reports. His answer was that I might be a candidate for ADR but he wanted me to get six level discogram before he would consider it. After doing some research into discograms I wasn't exactly happy about his demand. Are they really necessary? They sound medieval to me. Delamarter is the only doctor that has asked for this and so casually too. Considering the amount of pain this test would inflict, I would have liked a little more empathy. They could learn something about accommodating out of town patients from the folks in Germany.

I went in search of a doctor that might be more sympathetic and first do no harm, as their oath states.

I have been amazed at the fact that many of these doctors that are so called leaders in their field, do not know each of each other. I think we would provide a great service at this website and forum to start a list of doctors and allow members to rate and make comments about them. And I would suggest letting the doctors know we are doing this so they can see what the community thinks of them and to expose them to what other doctors are doing.

I will let you all know what I discover about Dr. Naraghi. I am due to meet with him on June 9th.

Thanks,
Gene

[epiphaknee]

Did Delamarter's office charge you to review your films and radiology reports?

Just curious what the standard protocol is!!!

[Westwind]

No, Delamarter did not charge me to do a preliminary look at my films and reports. I am not sure how thorough they were at this point, since have only communicated with them by phone, and have not seen the doctor in person.

On the other hand, Dr. Bertagnoli in Germany, charges close to $500 to review your case.

So I would assume it varies from doctor to doctor, but it has been my experience that American doctors will only charge for office visits and the cost of reviewing the film in detail is usually charged by the radiologist.

Gene

[LBP]

I've had 2 diskograms done for my lumbar region. When I was finally approved for surgery, my spine surgeon left it up to my discretion whether to have an updated one.

If you are seriously contemplating serious spine surgery, YES get the diskogram!!!! It is a very important diagnostic tool to determine what levels need surgerical intervention.

Some drs will offer a mild sedative. They described to me that I was in a state that they could adjust my sedative state as needed to perform the test. I could wake up and describe pain IF I felt it, and if I didn't feel pain, I stayed "out of it."

For me the worst pain was after I got home and the anethesia wore off. Luckily I had vicodin at home to deal with that pain.

Also, If you're going to have the diskogram done, see if they can do a CT scan right afterwards. That way the contrast injected during the diskogram will show up on the CT scan and you should have a clearer view of what's going on in your spine!

I had tears in my discs. It was very easy for me (a "lay person") to see the difference between the health control discs vs the unhealthy torn discs.

[CindyLou]

I couldn't agree more with LBP. You definitely only want to have surgery on pain generators. Unfortunately, some diagnostic procedures just happen to cause pain. The discogram being one of them. However, they are extremely necessary in the diagnostic process. Maybe a scientist will invent the discogram that is pain free in the future. I would nominate him for the Nobel Peace Prize. Until then, buck up and submit, if you are serious about surgery. You won't regret it.

[ZorroSF]

don't ever underestimate your condition. Unless you're an ace at spine surgery and you're the best rehab specialist in the world, then you'll never be prepared enough.

You want to research which disc is causing the pain. Sometimes, like in my case, my facets were to blame and not neccessarily the disc. Had I known my facets were the pain generator it would've given the doctors a better idea that I was not a candidate for ADR and should've had a fusion.

Don't rush into surgery thinking you know it all. Nothing worse to come out of surgery to find out one year later that you're in the same or worse pain than you were pre-op.


BTW 1 daniel burnham court is just an office center. It looks like he works out of california pacific medical center. I think that's in laurel heights and has great nurses, so you'd be in good hands. I'm not sure about St. Luke's, never looked into it. It also looks like he uses charite instead of prodisc. I don't think it really matters.

[dorothy]

Hi Gene, I recently saw Dr. Delamarter and was asked to get discograms. I am in the process of groveling to my pcp in order to have them made.
I am still new to all this information, yet I do know some basics: disc heighth is critical to the sucess of an ADR-if the disc heigth is less than 3cm(some say 5), then all the ligaments, tendons, muscles have to stretch to accomodate. That constant pressure can cause tremendous pain. The second issue is facet arthropathy(arthritis in the facet joints). The best analogy I used to help myself understand is this: on old fashioned metal handcuffs, two hinges open up to accomdate the width of the wrist. If one hinge(or both) are stuck, they have no flexibility and won't close-with adr, the stuck joints will not "give" enough to let the adr fit in the area in which a disc used to be. I highly recommend you read "Anatasia's" story(go to find and enter her name.).Recently, Harrison listed all the contraindications for ADR-it is sobering and saddening and very illuminating. I was all ready to go deeply into debt at Stenum for two ADR(L4-S1), when it began to bother me that I would be travelling that far with surgery pre-determinied-since I have a failed bone plug fusion between C6-7, I could not risk it. I may have no options; since my piriformises hurt and have done for 7 years(many falls), I am going to check into treatment for piriformis/sciatica syndrome. Harrison's list of contraindications in under the forum for people who have had ADR surgery. Good researching-Dorothy P.S. Medtronics has a nerve destimulator which is implanted in the abdomen and the electrodes implanted near the sources of pain.

[Terry]

Gene:

I am so sorry about all that you have gone through. It sounds like you have a horrendous history with spinal damage and have a life ahead of you that you need to be comfortable enough to continue living it. I agree with everyone here about doing your homework. Life can be altered in a blink of an eye and it is too late after the fact sometimes.

There are probably several options for you and I am hopeful that you get more than one opinion. Long after the surgeons work is done you will still be around. The work you put in today may ensure a better outcome for you.

Please keep us informed and let us know how we can support you in this process. Welcome to the forum as well. There are a lot of good people here that care about each other. We are all in this together.

Terry Newton

[ans]

Dorthy and others: I urge you to come to LA and see several mavens in one trip for opinions. Not that I love the city vs. up north but there's some great talent here.

Wishing you folks well. - Allan