Advice needed on cervical ADR decision

[Cheryl0331]

Originally Posted by Throttlejockey

We too were biased against going to Europe. You would be crazy to not be! But at the end of the day we wanted to have someone with the professional edge and selected Dr. Clavel.

First of all, as a professional pilot, I can tell you that the riskiest pilots are the ones that know how to operate the airplane, but lack experience in its peculiarities and seasoning in the cockpit. We call these guys "High Mins" Captains - they are allowed to fly the line, but are not allowed to fly in challenging conditions. So when the weather is bad, the company substitutes a more experienced guy for the flight.

Like pilots, we found that many of the highly regarded US surgeons whose names are often tossed about on this forum are still "High Mins" surgeons. They can do the procedure well with exceptional outcomes. But if you exhibit a clinically challenging diagnosis, they will revert to recommend a fusion or hybrid just as Antifragile has experienced. Call it CYA or whatever, but it is really frustrating to get your hopes up, and then have them quickly dashed when they so NO and push for the fusion.

Our experience was that Dr. Clavel felt that he had a 95% chance of getting it done, but told us he would have the fusion device at the ready. We asked him why the US doctors didn't approach it the same way, and he suggested they likely didn't feel comfortable with de-compression at the C6/C7 due to the advanced stage of my wife's condition.

As for the Mobi-C vs M6, we preferred the constrained design of the M6 over the unconstrained design of the Mobi-C, but at the end of the day, the Mobi-C was OK for us and we were prepared to have the Mobi-C. However, since we could not find a US Surgeon who gave us any confidence they would do the procedure the Mobi-C was not an option. On the other hand, Dr. Clavel has a lot of experience with the M6. In addition, there have been over 32,000 of these devices implanted so far so it is not something new.

Finally while some get reimbursed by insurance (Congratulations! You're in the minority of the minority), most that require a multi-level do not. As one of the seven doctors we talked to here in the US said to us, "your insurance won't cover it, so why talk about something you can't have."

I believe that once the insurance issue is resolved, multi-level ADR will become more common, and the issues of experience and seasoning for US Surgeons will go away. Until then, this problem will persist.

Overall, so far, we believe the decision to go to Europe was the best decision we could make given the information we had at our disposal at that time. We are happy with Dr. Clavel and the professional staff in Barcelona, but only time will tell.

TJ

So this was due to the sever spinal stenosis that he may have had to fuse? You could have stayed here in the US for that. I am so thankful that he was able to do the ADR.

[Throttlejockey]

Dear Cheryl,

I wanted to comment on the two questions you posed.

The issue my wife had was that the C6-C7 the disc had degenerated so much that the vertebrae were very close to being bone on bone, with one of the bone spurs protruding into the nerve. It was suggested that auto-fusion had already begun to take place.

The best ADR surgeons out of Texas (TBI) did not feel comfortable recommending placement of the artificial disc in this position. They recommended a hybrid, and even said a two-level fusion may be the best solution.

Armed with this information my wife and I pressed Dr. Clavel during the consult, as we did not want to fly all the way to Spain only to get a surgery that we could have had here in the US or get pushed into a surgery that was not in her best interest, as we had heard of such cases in Germany.

Dr. Clavel was confident, but he told us how he was always prepared to make a change in the OR, and would have fusion devices standing by. That is when he gave us the 95-98% outcome for the ADR surgery.

This sold us on Dr. Clavel. It reflected a high confidence in his own skills and knowledge, but also a level of humility and a constrained ego. We perceived that a doctor that willingly shares what his "out" is, is a doctor that know their limits.

We are now 5 month post op. We had a recent consult with Dr. Clavel and my wife's X-Ray looks fantastic. Other than periodic mild soreness, she is feeling better today than she has felt in over 10 years. We are grateful for this forum as it has educated us on ADR and also for introducting us to Dr. Clavel. I am sure that there are other surgeons out there that may be just as talented as him, but I would suggest that the entire process of working with his team, and the fact that you are in a top hospital enviroment at Quiron, pushes him to the top. I would put him in the "highly recommended" column.

TJ

[drewrad]

Yep. On all counts.

I'm doing really well BTW. Now just allowing other discs higher up in spine not addressed time to rest and to heal. But all Dr Clavel's work down low at almost 9 months feels good to go.

[Antifragile]

Ok, so in here in Hattingen hospital and I'm scheduled to have surgery tomorrow. It's been a long road of decisions and exploring other options before I decided on this. The hospital is nice and the staff are very friendly. The menu looks good here!

[TPatti]

Originally Posted by Antifragile

Ok, so in here in Hattingen hospital and I'm scheduled to have surgery tomorrow. It's been a long road of decisions and exploring other options before I decided on this. The hospital is nice and the staff are very friendly. The menu looks good here!

I'll keep you in my prayers. Let me know if you have any questions while you are there.

[Cynlite]

You're in my thoughts and prayers for a very positive outcome and speedy recovery! I missed your earlier post that you had scheduled your surgery. Sorry, or I would have commented sooner. Be well and come home safely.

[Cynlite]

You're in my thoughts and prayers for a very positive outcome and speedy recovery! I missed your earlier post that you had scheduled your surgery. Sorry, or I would have commented sooner. Be well and come home safely a new man free of pain!

[JeffR]

I think anyone considering ADR should strongly consider Clavel for all the reason's mentioned earlier. The man is great at what he does, but knows the limits of the patient's physiology, his own skill, and the technology at hand. He makes great judgements and keeps you as part of the process.

Couldn't recommend him more highly, and have never doubted my own choice once.

[jss]

Antifragile, feeling better when you wake up than when they put you out is such a rush. Wishing that for you. Good luck tomorrow, you're going to do great!

[scoop302]

Antifragile, best of luck to you. I am anxious to hear how you are doing.